Prevalence and risk factors of anxiety and depression in patients with liver cirrhosis during the COVID-19 pandemic (preprint)

Background Patients with cirrhosis are prone to mental and psychological problems. However, data on mental and psychological problems in patients with cirrhosis during the coronavirus disease 2019 (COVID-19) pandemic are lacking. Therefore, we aimed to investigate the prevalence and risk factors of anxiety and depression in this population.Methods The Patient Health Questionnaire-9 Scale and Generalized Anxiety Disorder 7-item scale were used to collect mental health data in this cross-sectional study. Multivariate logistic regression analysis was performed to evaluate the relevant influencing factors of anxiety and depression.Results The prevalence rates of anxiety and depression in patients with cirrhosis were 21.3% and 29.9%, respectively. Anxiety risk was higher among patients with cirrhosis who had significant abdominal pain and treatment interruption; COVID-19 vaccination was associated with anxiety reduction as a protective factor. Depression risk was higher among patients with cirrhosis for > 10 years, significant abdominal pain within one week, and treatment interruption. Course of cirrhosis of 5–10 years and COVID-19 vaccination were associated with the reduction of depression as protective factors.Conclusion COVID-19 vaccination is a protective factor for both depression and anxiety. Our findings may help healthcare professionals to develop appropriate treatment strategies and timely psychological interventions.

CMC v2: Towards More Accurate COVID-19 Detection with Discriminative Video Priors (preprint)

This paper presents our solution for the 2nd COVID-19 Competition, occurring in the framework of the AIMIA Workshop at the European Conference on Computer Vision (ECCV 2022). In our approach, we employ the winning solution last year which uses a strong 3D Contrastive Mixup Classifcation network (CMC v1) as the baseline method, composed of contrastive representation learning and mixup classification. In this paper, we propose CMC v2 by introducing natural video priors to COVID-19 diagnosis. Specifcally, we adapt a pre-trained (on video dataset) video transformer backbone to COVID-19 detection. Moreover, advanced training strategies, including hybrid mixup and cutmix, slicelevel augmentation, and small resolution training are also utilized to boost the robustness and the generalization ability of the model. Among 14 participating teams, CMC v2 ranked 1st in the 2nd COVID-19 Competition with an average Macro F1 Score of 89.11%.

Boosting COVID-19 Severity Detection with Infection-aware Contrastive Mixup Classification (preprint)

This paper presents our solution for the 2nd COVID-19 Severity Detection Competition. This task aims to distinguish the Mild, Moderate, Severe, and Critical grades in COVID-19 chest CT images. In our approach, we devise a novel infection-aware 3D Contrastive Mixup Classification network for severity grading. Specifcally, we train two segmentation networks to first extract the lung region and then the inner lesion region. The lesion segmentation mask serves as complementary information for the original CT slices. To relieve the issue of imbalanced data distribution, we further improve the advanced Contrastive Mixup Classification network by weighted cross-entropy loss. On the COVID-19 severity detection leaderboard, our approach won the first place with a Macro F1 Score of 51.76%. It significantly outperforms the baseline method by over 11.46%.

Household transmission of SARS-CoV-2 during the Omicron wave in Shanghai, China：a case-ascertained study (preprint)

Since late 2021, the highly transmissible SARS-CoV-2 Omicron variant has driven a new surge of infections across the world. We used a case-ascertained study to determine the features of household transmission of SARS-CoV-2 Omicron variant in Shanghai, China. We collected detailed information on 323 pediatric cases and their 951 household members, all received consecutively intensive RT-PCR testing. We estimated the transmission parameters. Both secondary infection attack rates (SARI) and secondary clinical attack rates (SARC) among adult household contacts were computed, through which the transmission heterogeneities in infectivity and susceptibility were characterized and the vaccine effectiveness were estimated. The mean incubation period and serial interval of Omicron variant were estimated to be 4.6±2.1 days and 3.9±3.7 days. The overall SARI and SARC among adult household contacts were 77.11% (95% confidence interval [CI]: 73.58%-80.63%) and 67.03% (63.09%-70.98%). We found higher household susceptibility in females, while infectivity was not significantly different in primary cases by age, sex, vaccination status and clinical severity. Full vaccination and booster vaccination of inactivated vaccines were 14.8% (5.8%-22.9%) and 18.9% (9.0%-27.7%) effective against Omicron infection and 21.5% (10.4%-31.2%) and 24.3% (12.3%-34.7%) effective against symptomatic disease. Overall, we found high household transmission during the Omicron wave in Shanghai due to asymptomatic and pre-symptomatic transmission in the context of city-wide lockdown, indicating the importance of early detection and timely isolation of SARS-CoV-2 infections and quarantine of close contacts. Marginal effectiveness of inactivated vaccines against Omicron infection poses great challenge for prevention and control of the SARS-CoV-2 Omicron variant.

Household transmission of SARS-CoV-2 during the Omicron wave in Shanghai, China:a case-ascertained study (preprint)

Background Since late 2021, the highly transmissible SARS-CoV-2 Omicron variant has driven a new surge of infections across the world. We used a case-ascertained study to determine the features of household transmission of SARS-CoV-2 Omicron variant in Shanghai, China. Methods We collected detailed information on 323 pediatric cases and their 951 household members in April 2022 during the Omicron outbreak. All household members received consecutively intensive RT-PCR testing for SARS-CoV-2 and routine symptom monitoring within 14 days after exposure to a confirmed case. We described the characteristics of study participants and estimated the transmission parameters. Both secondary infection attack rates (SAR I ) and secondary clinical attack rates (SAR C ) among adult household contacts were computed, through which the transmission heterogeneities in infectivity and susceptibility were characterized and the vaccine effectiveness were estimated. Results We estimated the mean incubation period of SARS-CoV-2 Omicron variant to be 4.6 (median: 4.4, IQR: 3.1-6.0) days and the mean serial interval to be 3.9 (median:4.0, IQR: 1.4-6.5) days. The overall SAR I and SAR C among adult household contacts were 77.11% (95% confidence interval [CI]: 73.58%-80.63%) and 67.03% (63.09%-70.98%). We found higher household susceptibility in females, while infectivity was not significantly different in primary cases by age, sex, vaccination status and clinical severity. The estimated VEs of full vaccination was 14.8% (95% CI: 5.8%-22.9%) against Omicron infection and 21.5% (95% CI: 10.4%-31.2%) against symptomatic disease. The booster vaccination was 18.9% (95% CI: 9.0%-27.7%) and 24.3% (95% CI: 12.3%-34.7%) effective against infection and symptomatic disease, respectively. Conclusions We found high household transmission during the Omicron wave in Shanghai due to asymptomatic and pre-symptomatic transmission in the context of city-wide lockdown, indicating the importance of early detection and timely isolation of SARS-CoV-2 infections and quarantine of close contacts. Marginal effectiveness of inactivated vaccines against Omicron infection poses great challenge for prevention and control of the SARS-CoV-2 Omicron variant.

Point-of-care training program on COVID-19 infection prevention and control for pediatric healthcare workers (preprint)

Background: To evaluate the effectiveness of training on knowledge and practices of infection prevention and control (IPC) among pediatric health care workers (HCW) in Shanghai, China, in the context of COVID-19 pandemic. Methods: An online training program was designed by the Shanghai Pediatric Clinical Quality Control Center (SPQCC) during the early phase of COVID-19 pandemic on disease knowledge and practice of IPC. Training took place in the 81 partner hospitals affiliated with SPQCC. A 25-item self-administered questionnaire was used to evaluate knowledge gained from the training. Stratified-random sampling was used to select HCW according to three professionals (i.e., pediatricians, nurses and administrators) within each partner hospital. Awareness and knowledge of COVID-19 and its related infection control and practice was assessed by comparing survey results between different types of hospitals, professionals and professional ranks. A higher survey score meant that the respondent was more prepared and knowledgeable about COVID-19 and its infection control measures. Results: Completed questionnaires were returned from 1,062 subjects (385 pediatricians, 410 nurses, and 267 administrators), giving a response rate of 96.5%. Overall, awareness of clinical information related to COVID-19, importance of personal hygiene and isolation policy was high among the respondents. No statistical difference of scores on knowledge of COVID-19, IPC and relevant practice between the tertiary and peripheral hospitals. Among all respondents, middle-ranked health care personnel were most knowledgeable and achieved the highest score. Conclusions: Majority of pediatric HCW showed good recognition and practice in infection protection and control measures. The online training was able to achieve its aim to enhance knowledge and awareness and could have contributed to the zero infection rate among HCW caring for confirmed COVID-19 cases in Shanghai.

Experts proposal and frequently asked questions of rapid screening and prevention of novel coronavirus pneumonia in children / 中华实用儿科临床杂志

The outbreak of novel coronavirus pneumonia (NCP) has become the most severe public health issue at the moment, threatening people′s lives. Pediatricians in Shanghai have recently launched a discussion on the focused questions of NCP, including the incidence situation, epidemiological features, essentials of early screening, treatment and nosocomial infection prevention of children′s novel coronavirus infection (2019-nCoV), and further put forward the experts proposal upon the patterns of disease occurrence, development, diagnosis and control, for the reference of frontline pediatricians.