Comprehensive Overview of Broadly Neutralizing Antibodies against SARS-COV-2 Variants (preprint)

Currently, SARS-CoV-2 has evolved into various variants, including the numerous highly mutated Omicron sub-lineages, significantly increasing immune evasion ability. The development raises concerns about possibly diminished effectiveness of available vaccines and antibody-based therapeutics. Here, we describe those representative categories of broadly neutralizing antibodies (bnAbs) that retain prominent effectiveness against emerging variants including Omicron sub-lineages. The molecular characteristics, epitope conservation, and resistance mechanisms of these antibodies are further detailed, aiming to offer suggestion or direction for the development of therapeutic antibodies, and facilitate the vaccine design with broad-spectrum potential.

A Review and Perspective of Environmental Disinfection Technology Based on Microwave Irradiation

Purpose of Review In the context of COVID-19 sweeping the world, the development of microbial disinfection methods in gas, liquid, and solid media has received widespread attention from researchers. As a disinfection technology that can adapt to different environmental media, microwave-assisted disinfection has the advantages of strong permeability, no secondary pollution, etc. The purpose of this review is to put forward new development requirements for future microwave disinfection strategies by summarizing current microwave disinfection methods and effects. From the perspective of the interaction mechanism of microwave and microorganisms, this review provides a development direction for more accurate and microscopic disinfection mechanism research. Recent Findings Compared to other traditional environmental disinfection techniques, microwave-assisted disinfection means have the advantages of being more destructive, free of secondary contamination, and thorough. Currently, researchers generally agree that the efficiency of microwave disinfection is the result of a combination of thermal and non-thermal effects. However, the performance of microwave disinfection shows the differences in the face of different environmental media as well as different types of microorganisms. Summary This review highlights the inactivation mechanism of microwave-assisted disinfection techniques used in different scenarios. Suggestions for promoting the efficiency and overcoming the limitations of low energy utilization, complex reactor design, and inaccurate monitoring methods are proposed.

The Association between Physical Activity, Self-Compassion, and Mental Well-Being after COVID-19: In the Exercise and Self-Esteem Model Revised with Self-Compassion (EXSEM-SC) Perspective.

During the great life-altering challenges brought by Coronavirus 2019, school closures and lack of access to exercise and social interactions may have increased students' negative emotions. The current research acts as a follow-up study to the development of the EXSEM-SC, using the Repeated Measures Panel Analysis Framework (RMPAF) to examine the stability of the model in revealing the relationship between physical activity, self-compassion, and mental well-being among Hong Kong adolescents. It is also aimed at examining the changes in physical activity, self-compassion, and mental well-being among Hong Kong adolescents between, before, and after the peak of COVID-19 using the EXSEM-SC Model. The RMPAF has involved 572 (60% Female, Mage = 13.63, SD =1.31) Hong Kong secondary school students. Furthermore, using the abductive qualitative approach, a total of 25 (Mage = 14.84, SD = 1.40) students were involved in the in-depth interviews to further investigate the relationships within the EXSEM-SC. The quantitative results showed that the relationship between physical activity and self-compassion could be demonstrated by the EXSEM-SC, with a satisfactory goodness-of-fit index in the SEMs, as well as satisfying model construct consistency. Moreover, it showed no significant differences in the level of physical activity, self-compassion, and mental well-being during and after the peak of COVID-19. The qualitative results demonstrated two new categories within the EXSEM-SC variables, which are personality traits and injuries experiences. With the stability of the EXSEM-SC model among adolescents, it is expected that the physical activity intervention, which is based on the EXSEM-SC model, could also aim at easing Hong Kong adolescent's mental health issues. In addition, in terms of generating a long-term impact among students, the physical activity and self-compassionate intervention should be promoted among schools. However, the quantitative properties of the two new categories in the qualitative outcomes should be involved in future investigation.

The reliability and integrity of overall survival data based on follow-up records only and potential solutions to the challenges

Summary Overall survival (OS) is considered the standard clinical endpoint to support effectiveness claims in new drug applications globally, particularly for lethal conditions such as cancer. However, the source and reliability of OS in the setting of clinical trials have seldom been doubted and discussed. This study first raised the common issue that data integrity and reliability are doubtful when we collect OS information or other time-to-event endpoints based solely on simple follow-up records by investigators without supporting material, especially since the 2019 COVID-19 pandemic. Then, two rounds of discussions with 30 Chinese experts were held and 12 potential source scenarios of three methods for obtaining the time of death of participants, including death certificate, death record and follow-up record, were sorted out and analysed. With a comprehensive assessment of the 12 scenarios by legitimacy, data reliability, data acquisition efficiency, difficulty of data acquisition, and coverage of participants, both short-term and long-term recommended sources, overall strategies and detailed measures for improving the integrity and reliability of death date are presented. In the short term, we suggest integrated sources such as public security systems made available to drug inspection centres appropriately as soon as possible to strengthen supervision. Death certificates provided by participants’ family members and detailed standard follow-up records are recommended to investigators as the two channels of mutual compensation, and the acquisition of supporting materials is encouraged as long as it is not prohibited legally. Moreover, we expect that the sharing of electronic medical records and the legal disclosure of death records in established health registries can be realized with the joint efforts of the whole industry in the long-term. The above proposed solutions are mainly based on the context of China and can also provide reference for other countries in the world.

Postpartum Depressive Symptoms, Perceived Social Support and Their Associations of Women Under Different COVID-19 Pandemic Severities: Analysis of A Chinese Nationwide Multicenter Study (preprint)

Background The evidence for associations of mental health with COVID-19 pandemic severity is scarce in postpartum women. We aimed to investigate the associations of postpartum depressive symptoms (PDS), perceived social support (PSS) with COVID-19 pandemic severity, respectively, and to explore the associations between PSS and PDS under different pandemic severities.Methods This was a nationwide multicenter study. An online survey was launched from January 23 through February 29, 2020 in mainland China. Participants’ PDS and PSS were measured by Edinburgh Postnatal Depression Scale and Multidimensional Scale of Perceived Social Support, respectively.Results The final sample consisted of 452 participants from 19 hospitals in 19 provinces/municipalities of mainland China. After covariate adjustment, women in Hubei Province experienced higher PDS levels than those in moderate (β coefficient = − 3.883, p = 0.001) and high (β coefficient = − 3.760, p = 0.005) pandemic severity; women in moderate pandemic severity reported higher PSS levels not only than those in high (β coefficient = − 4.947, p = 0.008) pandemic severity and Hubei Province (β coefficient = − 6.480, p = 0.049), but also than low (β coefficient = − 7.428, p = 0.005) pandemic severity. Also, no significant associations were found between PSS and pandemic severity for women with moderate-to-severe PDS (p > 0.05). There were significantly negative associations between PSS and PDS for women under low (OR = 0.837, p = 0.039), moderate (OR = 0.919, p < 0.001), and high (OR = 0.951, p = 0.012) pandemic severity, and no significant association between PSS and PDS was observed in Hubei Province after covariate adjustment (p > 0.05).Conclusion Women in Hubei Province experienced higher PDS levels than those in moderate and high pandemic severity. Women in moderate pandemic severity reported higher PSS levels not only than those in high pandemic severity and Hubei Province, but also than low pandemic severity, and no associations were found between PSS and pandemic severity for women with moderate-to-severe PDS. There were negative associations between PSS and PDS for women in low, moderate and high pandemic severity, but no association between PSS and PDS of women in Hubei Province.

The imaging and clinical characteristics of patients with immune breakthrough Omicron-variant infected patients, Tianjin China: Is the vaccine effective? (preprint)

Background The protective effect of the inactivated vaccine against the omicron variant of COVID-19 is unclear. The purpose of this study was to investigate the protective effect of different vaccination status on omicron infection.Methods In this retrospective study, we analyzed patients over 14 years old, and were diagnosed with immune breakthrough Omicron-variant infection between December 2021 and February 2022 in Tianjin, China, as well as data from several previous study infected by other types of SARS-CoV-2. The data were subdivided into three groups: patients with fully, partially and unvaccine. Differences of clinical and imaging characteristics were compared based on the different vaccination status using Pearson Chi-square test, Fisher's accuracy test and non-parametric test. All of the data were also compared with other types of SARS-CoV-2. Logistic regression and mediation effect analysis were used to assess the association between vaccination status and pneumonia progression during hospitalization.Results Among the 314 cases of immune breakthrough Omicron-variant infected patients, 21(7%) patients were unvaccinated, 134 (43%) were partially vaccinated, and 159 (50%) were full vaccinated. Among fully vaccinated patients, the proportion of patients with positive CT findings (32%) and CT score 2 (6%) was significantly lower than that of partially vaccinated (46%, 14%) and unvaccinated patients (67%, 19%) (P < 0.05). CT score by vaccination status are similar between Omicron and other types, only partially vaccinated group of Omicron infected patients show lower CT score than other types infected patients (P = 0.005). Increased age and lower IgG levels were associated with the risk of disease progression. IgG level had a complete mediating effect between vaccination status/ days after vaccination and disease progression.Conclusion The inactivated vaccine provided similar protection against Omicron infection of SARS-CoV-2, compared to the patients who received other types vaccines. Compared with partially vaccinated and unvaccinated patients, fully vaccinated patients had a higher CT negative rate and a lower rate of severe pneumonia. Vaccination status and days after vaccination affect disease progression through IgG levels.

The risk factors and outcomes for radiological abnormalities in early convalescence of COVID-19 patients caused by the SARS-CoV-2 Omicron variant in Tianjin, China: a retrospective, multicenter follow-up study (preprint)

Background: The emergence of the SARS-CoV-2 Omicron variant has been triggering the new wave of COVID-19 globally. However, the risk factors and outcomes for radiological abnormalities in the early convalescent stage (1 month after onset) of Omicron infected patients are still unknown.Methods: Patients were retrospectively enrolled if they were admitted to the hospital due to COVID-19 and underwent chest CT scans during hospitalization between 8 January and 24 February 2022. The chest CTs and clinical data obtained at admission and 1 month after onset were longitudinally analyzed. Spearman rank correlation analysis was used to investigate the correlation between laboratory markers and CT scores. Uni-/multi-variable logistic regression tests were performed to explore independent risk factors for radiological abnormalities at admission and residual pulmonary abnormalities after 1 month. Results: We assessed 316 COVID-19 patients, including 47% with radiological abnormalities at admission and 23% with residual pulmonary abnormalities at 1-month follow-up. In a multivariate regression analysis, age ≥ 50 years, body mass index ≥ 23.87, days after vaccination ≥ 81 days, lymphocyte count ≤ 1.21×10-9/L, Interleukin-6 ≥ 10.05 pg/mL and IgG ≤ 14.140 S/CO were independent risk factors for CT abnormalities at admission (odds ratio = 2.870, 4.171, 2.360, 2.826, 3.886 and 2.828, respectively; P < 0.05 for each comparison). The presence of interlobular septal thickening and IL-6 ≥ 5.85 pg/mL were the independent risk factors for residual pulmonary abnormalities at 1-month follow-up (odds ratio = 3.619 and 3.197, respectively; P < 0.05 for each comparison). There were no significant changes in the number of involved lung lobes (P = 0.308) and total CT score (P = 0.068) during the early convalescent stage. And the level of IL-6 showed positive correlation with CT score at admission (spearman r = 0.202, P = 0.030).Conclusions: The higher IL-6 level was a common independent risk factor for CT abnormalities at admission and residual pulmonary abnormalities at 1-month follow-up. And there were no obvious radiographic changes during the early convalescent stage in patients with residual pulmonary abnormalities. 

A rapid water bath PCR combined with lateral flow assay for the simultaneous detection of SARS-CoV-2 and influenza B virus† † Electronic supplementary information (ESI) available. See DOI: 10.1039/d1ra07756b

The outbreak of the coronavirus disease 2019 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted in significant global health and economic threats to the human society. Thus, a rapid and accurate detection method for early testing and diagnosis should be established. In this study, a rapid water bath polymerase chain reaction (PCR) combined with lateral flow assay was developed to detect SARS-CoV-2 and influenza B virus simultaneously. A homemade automated transfer device equipped with reaction tube shuttled rapidly between two water baths at 98 °C and 53 °C to realize rapid PCR. After amplification, two-ended labeled PCR products were detected using the lateral flow strip with two test lines and streptavidin-conjugated quantum dot nanobeads. The fluorescence value was read using a handheld instrument. The established assay could complete reverse-transcription PCR amplification and lateral flow detection in 45 minutes. The detection limits were 8.44 copies per μL and 14.23 copies per μL for SARS-CoV-2 and influenza B virus, respectively. The coefficients of variation of the test strip were 10.10% for the SARS-CoV-2 and 4.94% for the influenza B virus, demonstrating the excellent repeatability of the experiment. These results indicated that the rapid PCR combined with lateral flow assay could detect SARS-CoV-2 and influenza B virus simultaneously at a short assay time and low cost, thereby showing the remarkable potential for the rapid and multiplex detection of respiratory viruses in resource-limited settings. Rapid and highly sensitive multiplex detection of SARS-CoV-2 and influenza B virus using water bath PCR-combined fluorescent lateral flow assay.

Does flattening the curve make a difference? An investigation of the COVID-19 pandemic based on an SIR model

We use a susceptible-infective-removed (SIR) model to examine the impacts of different isolation measures to combat the COVID-19 pandemic. The model predicts that strong isolation measures in the early stage of the pandemic can not only delay the time for the number of infections and deaths to reach the peak but also greatly reduce the cumulative number of infections and deaths. We verify the model predictions by using the simulation and the data of the COVID-19 cases. The results are independent of the joint distribution of the fatality rate and the initial number of active cases.

Thyroid Hormone Changes in the Northern Area of Tianjin during the COVID-19 Pandemic.

PURPOSE: This study aimed to determine whether and how stress-induced thyroid hormone changes occur during the COVID-19 pandemic in the northern area of Tianjin. METHODS: This study comprised two groups of study subjects in Tianjin: before (2019) and during (2020) the COVID-19 outbreak. Subjects were included if they had FT3, FT4, and TSH concentrations and thyroid TPOAb or TgAb information available. People who were pregnant, were lactating, or had mental illness were excluded. We used propensity score matching to form a cohort in which patients had similar baseline characteristics, and their anxiety level was measured by the Hamilton Anxiety Rating Scale (HAMA). RESULTS: Among the 1395 eligible people, 224 in Group A and 224 in Group B had similar propensity scores and were included in the analyses. The detection rate of abnormal thyroid function was decreased in pandemic Group B (69.2% vs. 93.3%, χ 2 = 42.725, p < 0.01), especially for hypothyroidism (14.29% vs. 35.71%, χ 2 = 27.429, p < 0.01) and isolated thyroid-related antibodies (25.89% vs. 38.39%, χ 2 = 8.023, p < 0.01). The level of FT4 (z = -2.821, p < 0.01) and HAMA score (7.63 ± 2.07 vs. 5.40 ± 1.65, t = 16.873, p < 0.01) went up in Group B; however, TSH (z = -5.238, p < 0.01), FT3 (z = -3.089, p=0.002), TgAb (z = -11.814, p < 0.01), and TPOAb (z = -9.299, p < 0.01) were lower, and HAMA was positive with FT3 (r = 0.208, p < 0.01) and FT4 (r = 0.247, p < 0.01). CONCLUSION: People in the northern area of Tianjin during the COVID-19 outbreak were at an increased risk of higher FT4, lower FT3, and lower TSH. The HAMA scores increased in emergency situations and were positively correlated with the levels of FT3 and FT4.

A Meta-Analysis of Accuracy and Sensitivity of CRISPR and Chest CT in COVID‑19 Diagnosis (preprint)

Objective: To clarify the accuracy of clusters of regularly spaced short palindrome repeats (CRISPR) technology and chest CT in the diagnosis of Corona Virus Disease2019(COVID-19). Methods: The term "Corona Virus Disease " "clustered regularly spaced short palindromic repeats" "CRISPR", "chest CT", "sensitivity and specificity" as the subject words or keywords were searched in databases such as Pubmed, Embase, Cochrane Library, Wiley and Scopus and Chinese academic databases (such as CNKI, Wanfang and Chongqing VIP data) for relevant literature on the use of CRISPR technology and chest CT for the diagnosis of COVID-19. Meta-analysis was performed after literature screening, quality assessment and data extraction . Results: A total of 418 articles were retrieved, and 17 articles were finally included. The results showed that the combined sensitivity of CRISPR technology for diagnosing new coronary pneumonia infection was 0.96 [95% CI (0.93, 0.98)], and the combined specificity was 1.00 [95% CI (0.92, 1.00)], the combined positive likelihood ratio is 458.69 [95%CI (11.51, 18280.8)], the combined negative likelihood ratio is 0.04 [95% CI (0.02, 0.07)], the area under the SROC curve is 0.99 [95%CI(0.97,0.99)]. The combined sensitivity of chest CT in diagnosing new coronary pneumonia infection was 0.94 [95%CI (0.83, 0.98)], combined specificity was 0.55 [95% CI (0.22, 0.83)], combined diagnostic odds ratio was 19.90 [95% CI (7.88, 50.25)], the combined positive likelihood ratio is 2.08 [95%CI (1.00, 4.32)], the combined negative likelihood ratio is 0.10 [95% CI (0.05, 0.23)], the area under the SROC curve is 0.91 [95% CI (0.88, 0.93)]. The Deek funnel chart indicates that there is no potential publication bias among the included studies (PCRISPR = 0.03, P chest CT = 0.55). Conclusion: CRISPR technology has a better ability to detect infections in patients with COVID-19, and is better than chest CT in disease diagnosis. CRISPR technology, especially non-SHERLOCK type and multi-target gene detection, can be used to diagnose COVID-19 with higher accuracy ,and can be used for large-scale population screening.

The Acceptance of COVID-19 Vaccination Under Different Methods of Investigation: Based on Online and On-Site Surveys in China

As Coronavirus Disease-2019 (COVID-19) vaccines became available in December 2020, increasingly more surveys were organized to examine the acceptance of vaccination, while most of them were conducted online. This study aimed to explore the difference between online and traditional on-site surveys in terms of COVID-19 vaccine acceptance. From November to December 2020, an online survey (n = 2013) and an on-site survey (n = 4,316) were conducted simultaneously in China. Multivariate logistic regression was used to identify influencing factors of acceptance, and propensity score matching (PSM) was adopted to balance the outcomes. As a result, 90.0% of the online respondents accepted COVID-19 vaccination, while it was only 82.1% in the on-site survey. After applying PSM, the acceptance rate of the on-site survey was declined to 78.6%. The age structure, residence location, education, and health status were observed as important factors in addressing vaccination acceptance, which needed to be specifically considered when designing online surveys.

Severe COVID-19-associated sepsis is different from classical sepsis induced by pulmonary infection with carbapenem-resistant klebsiella pneumonia (CrKP)

Purpose COVID-19 is also referred to as a typical viral septic pulmonary infection by 2019-nCoV. However, little is known regarding its characteristics in terms of systemic inflammation and organ injury, especially compared with classical bacterial sepsis. This article aims to learn the clinical characteristics and prognosis between COVID-19-associated sepsis and classic bacterial-induced sepsis. Methods In this retrospective cohort study, septic patients with COVID-19 in the intensive care unit (ICU) of a government-designed therapy center in Shenzhen, China between Jan 14, 2020 and Mar 10, 2020, and septic patients induced by carbapenem-resistant klebsiella pneumonia (CrKP) admitted at the ICU of the Second People’s Hospital of Shenzhen, China between Jan 1, 2014 and Oct 30, 2019, were enrolled. Demographic & clinical parameters including comorbidities, critical illness scores, treatment, and laboratory data, as well as prognosis were compared between the two groups. Risk factors for mortality and survival rate were analyzed using multivariable logistic regression and survival curve. Results A total of 107 patients with COVID-19 and 63 patients with CrKP were enrolled. A direct comparison between the two groups demonstrated more serious degrees of primary lung injury following 2019-nCoV infection (indicated by lower PaO2/FiO2) but milder systemic inflammatory response, lower sequential organ failure assessment (SOFA) score and better functions of the organs like heart, liver, kidney, coagulation, and circulation. However, the acquired immunosuppression presented in COVID-19 patients was more severe, which presented as lower lymphocyte counts. Moreover, the proportion of COVID-19 patients treated with corticosteroid therapy and extracorporeal membrane oxygenation was larger compared with CrKP patients who required less invasive mechanical ventilation. The incidence of hospitalized mortality and length of ICU stay and total hospital stay were also lower or shorter in viral sepsis. Similar results were obtained after being adjusted by age, gender, comorbidity and PaO2/FiO2. Lymphocytopenia and high acute physiology and chronic health evaluation II (APACH II) scores were common risk factors for in-hospital death. While the death cases of COVID-19 sepsis mostly occurred at the later stages of patients’ hospital stay. Conclusion Critical COVID-19 shares clinical characteristics with classical bacterial sepsis, but the degree of systemic inflammatory response, secondary organ damage and mortality rate are less severe. However, following 2019-nCoV infection, the level of immunosuppression may be increased and thus induce in more death at the later stage of patients’ hospital stay.

Dynamic impact of negative public sentiment on agricultural product prices during COVID-19

The COVID-19 pandemic has had a significantly negative impact on public sentiment, which has resulted in panic and some irrational buying behavior, which in turn has had a complex impact on agricultural product prices. This study quantified online negative sentiment using micro-blog text mining and a time-varying parameter vector autoregressive model (TVP-VAR) to empirically analyze the dynamic impact of negative public emotions on agricultural product prices during the COVID-19 pandemic in China. It was found that the online negative sentiment impacted agricultural products prices during COVID-19 and had significant time-varying, lag, and life cycle characteristics, with the responses being most significant in the spread and recession periods. Differences were found in the price responses for different agricultural products and in different risk areas. The online negative sentiment was found to have the greatest impact on vegetable prices, with livestock products and vegetable prices being mainly positively impacted, fruit prices being mainly negatively impacted, and aquatic product prices being negatively impacted in the early stage and positively impacted in the middle and late stages. The online negative sentiment had the greatest impact on medium-risk area agricultural product prices, followed by low-risk areas, with the lowest impact found on the high-risk area agricultural product prices. Three policy suggestions for epidemic monitoring, public opinion guidance and control, and the timely release of agricultural product information are given based on the results.

Home Nursing for Disabled Elderly Patients during Corona Virus Disease 2019 in Wuhan City

Abstract: Objective: To provide door-to-door nursing service for disabled elderly patients during Corona Virus Disease 2019, so as to ensure patient safety and improve service quality. Methods: Set up home visiting service commando team, reengineer the visiting process, do a good job in hierarchical management, strengthen the protection of medical staff, patients and their families, and provide online and offline health education guidance. Results: there were 178 cases of on-site service, including 44 emergency cases and 134 non emergency cases;69 times of dressing change, 85 times of catheter change, 19 times of gastric tube change, 71 times of bladder irrigation, 6 times of health assessment and 2 times of foot disease treatment. All the visiting officers Corona Virus Disease 2019 suspected or confirmed cases to do their own protection, no cross infection occurred in 1 cases. Conclusion: during the epidemic period of Corona Virus Disease 2019, the needs of elderly patients with disability were met, which provided practical experience for dealing with public health emergencies and preventing the risk of infectious diseases.

Epidemiological characteristics of 42 cases of COVID-19 in Dazhou, Sichuan

Objective: To analyze epidemiological characteristics of coronavirus disease 2019 (COVID-19) in Dazhou City, we provide a scientific basis for prevention and control of COVID-19 in Dazhou City.

Network Complexity and Financial Behavior – Volume Distribution over Price in Financial Market (preprint)

A complex system consists of a lot of interactive individuals, agents, or units. It occurs widely but is hard to model in both natural and social sciences. Its behavior is neither regular nor random. However, it has some kinds of structures which capture our interesting to study. We can apply network theories to analyze the behaviors of a complex system which we can find almost everywhere in physics, chemistry, bioscience, psychology, sociology, organization structure, urban traffic, and economics and finance etc. After a brief perspective on the historical development and applications from networks to complex networks, this review converges to the application in finance. We do so, partly because there are abundant trading big data every day available for the empirical tests that have already rejected basic assumptions in neoclassical finance over the past 40 years, and partly because market participants or agents are interacted themselves with one another and have been adequately studied in empirical tests. Today, we have already come at a turning point in behavioral and social finance since its empirical revolution, from which someone is destined to propose a unified theory in the history of economic sciences. The theory based on a price-volume probability wave differential equation views stock market as the complex networks that lie between price random walks and long-term predictable price dynamic equilibriums in terms of its fundamentals. There are many ‘small-world’ market dynamic equilibriums, which are displayed by intraday cumulative trading volume distributions over a price range (nodes) and connected by the nonlinear jump return of a price equilibrium point (edges). Following this direction, we attempt to further develop a theory for complex networks, control systems, systems sciences, and cognitive intelligent sciences. It helps us understand an interactive society, suggesting policy guidance on quarantine and mask wearing against COVID-19 pandemic.

COVID-19 Quarantine Reveals Grade-specific Behavioral Modification of Myopia: One-Million Chinese Schoolchildren Study (preprint)

BackgroundHigh prevalence of myopia of adolescent has been a global public health concern. Their risk factors and effective prevention methods for myopia across schoolchildren developmental stages are critically needed but remain uncertain due to the difficulty in implementing intervention measurements under normal life situation. We aimed to study the impact of the COVID-19 quarantine on myopia development among over one-million schoolchildren. MethodsWe designed the ongoing longitudinal project of Myopic Epidemiology and Intervention Study (MEIS) to biannually examine myopia among millions of schoolchildren for ten years in Wenzhou City, Zhejiang Province, China. In the present study, we performed three examinations of myopia in 1,305 elementary and high schools for schoolchildren in June 2019, December 2019 and June 2020. We used the normal period (June-December 2019) and COVID-19 quarantine period (January-June 2020) for comparisons. Myopia was defined as an uncorrected visual acuity of 20/25 or less and a spherical equivalent refraction (SER) of -0.5 diopters (D) or less. High myopia was defined as an SER of -6.0 D or less. FindingsIn June 2019, 1,001,749 students aged 7-18 were eligible for examinations. In the 6-month and 12-month follow-up studies, there were 813,755 eligible students (81.2%) and 768,492 eligible students (76.7%), respectively. Among all students, we found that half-year myopia progression increased approximate 1.5 times from -0.263 D (95% CI, -0.262 to -0.264) during normal period to -0.39 D (95% CI, -0.389 to -0.391) during COVID-19 quarantine (P < 0.001). Multivariate Cox regression analysis identified grade rather than age was significantly associated with myopia (Hazard ratio [HR]: 1.10, 95% CI, 1.08 to 1.13; P < 0.001) and high myopia (HR: 1.40, 95% CI, 1.35 to 1.46; P < 0.001) after adjustment for other factors. The prevalence, progression, and incidence of myopia and high myopia could be categorized into two grade groups: I (grades 1-6) and II (grades 7-12). Specifically, COVID-19 quarantine for 6 months sufficiently increased risk of developing myopia (OR: 1.36, 95% CI, 1.33 to 1.40) or high myopia (OR: 1.30, 95% CI, 1.22 to 1.39) in Grade Group I, but decreased risk of developing myopia (OR: 0.45, 95% CI, 0.43 to 0.48) or high myopia (OR: 0.57, 95% CI, 0.54 to 0.59) in Grade Group II. InterpretationThe finding that behavioral modifications for six months during COVID-19 quarantine sufficiently and grade-specifically modify myopia development offers the largest human behavioral intervention data at the one million scale to identify the grade-specific causal factors and effective prevention methods for guiding the formulation of myopia prevention and control policies. FundingKey Program of National Natural Science Foundation of China; the National Natural Science Foundation of China; Scientific Research Foundation for Talents of Wenzhou Medical University; Key Research and Development Program of Zhejiang Province. Research in contextO_ST_ABSEvidence before this studyC_ST_ABSMyopia is the most-common refractive error worldwide. Myopia with younger onset may result in developing high myopia, which is associated with sight-threatening ocular diseases such as maculopathy, retinal detachment, opticneuropathy, glaucoma, retinal atrophy, choroidal neovascularization. In light of the increasing prevalence of myopia and high myopia has been a global public health concern, the impact of COVID-19 lockdown on myopia development has gained substantial attention. We searched PubMed, Google Scholar, and MEDLINE databases for original articles reported between database inception and November 10, 2020, using the following search terms: (coronavirus OR COVID* OR SARS-COV-2 OR lockdown OR quarantine) AND (myopia OR short-sightedness OR refractive error). To date, there was no original study reported to uncover the influence of COVID-19 quarantine on myopia progression. Added value of this studyThis study provides the largest longitudinal intervention data on myopia progression in Chinese schoolchildren covering all grades of schoolchildren at one-million scale. COVID-19 quarantine model uncovers that behavioral modifications for six months may lead to significant increase of overall prevalence of myopia associated with their increased screen times and decreased outdoor activity times. Importantly, their effects on developing myopia or high myopia of students are grade-dependent, which were risk factors for elementary schools period but protective factors for high schools period partly due to reduced school education burden. Implications of all the available evidenceThis one-million schoolchildren myopia survey offers evidence that six months behavioral modifications sufficiently and grade-specifically change the progression of myopia and high myopia. In view of the increased use of electronic devices is an unavoidable trend, effective myopia prevention strategy according to grade among students is urgently needed. Since COVID-19 outbreak is still ongoing and spreading, international collaborate efforts are warranted to uncover the influence of COVID-19 on myopia progression to further substantiate these findings.

Kidney damage in COVID-19 patients with or without chronic kidney disease: Analysis of clinical characteristics and related risk factors

COVID-19 poses more risk to patients who already suffer from other diseases, particularly respiratory disorder. In this study, we analyzed the clinical characteristics and related risk factors during hospitalization of COVID-19 patients admitted with kidney damage. A total of 102 COVID-19 patients with kidney damage [irrespective of their chronic kidney disease (CKD) history] during hospitalization were included in this study. The patients were divided into a core group and a group who developed critical illness or death. Clinical data included age, gender, length of hospitalization, clinical manifestations, medical history, hypersensitive C-reactive protein (hs -CRP), high serum creatinine, low cardiac troponin I (cTnI), and hemoglobin. Univariate and multivariate logistic regression models were used to analyze the risk factors of patients' outcome. Among the outcomes, 75 patients (73.53%) were cured, 27 (26.47%) developed to critical illness or death, 20 (19.61%) of them died. A total of 36 (4.26%) out of 845 COVID-19 patients, developed acute kidney injury (AKI). Decreased oxygen saturation, elevated hs-CRP, elevated serum creatinine, elevated cTnI, and anemia were related factors for COVID-19 patients who developed to critical illness or death (P <0.05). Decreased oxygen saturation, elevated hs-CRP and anemia were not independent factors, but elevated serum creatinine and elevated cTnI were independent factors for COVID-19 patients who developed to critical illness or death (P <0.05). Among COVID-19 patients with or without CKD but with kidney damage during hospitalization, patients with elevated serum creatinine and elevated Tnl, more likely to developed critical illness or death.