Research progress on influence of environmental and meteorological parameters on transmission of coronavirus disease 2019

Novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) is spreading rapidly around the world and has become a global pandemic. Meteorological factors have been recognized as one of the critical factors that influence the epidemiology and transmission of infectious diseases. In this context, the World Meteorological Organization and scholars at home and abroad have paid extensive attention to the relationships of environment and meteorology with COVID-19. This paper systematically collected and sorted out relevant domestic and foreign studies, and reviewed the latest research progress on the impact of environmental and meteorological factors on COVID-19, classifying them into typical meteorological factors (such as temperature, humidity, and wind speed), local environmental factors (such as indoor enclosed environment, ventilation, disinfection, and air conditioning), and air pollution. Current research evidence suggests that typical meteorological factors, local environmental factors, and air pollutants are closely related to the transmission of COVID-19. However, the results of different studies are still divergent due to uncertainty about the influencing mechanism, and differences in research areas and methods. This review elucidated the importance of environmental and meteorological factors to the spread of COVID-19, and provided useful implications for the control of further large-scale transmission of COVID-19 and the development of prevention and control strategies under different environmental and meteorological conditions.Copyright © 2022, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.

Efficacy and toxicity of carboplatin and gemcitabine dosed on day 1/day 8 versus day 1 alone for platinum-sensitive recurrent epithelial ovarian cancer

Background: Carboplatin, gemcitabine +/-bevacizumab is a preferred regimen for recurrent, platinumsensitive ovarian cancer (PSOC). A phase III trial established that the regimen of carboplatin on Day 1 (D1) and gemcitabine on D1 and Day 8 (D8) was associated with acceptable toxicity and improved progression free survival (PFS) compared to carboplatin alone. Treatment with gemcitabine on D8 incurs more exposure to cytotoxic therapy and increased burden on patients and the healthcare system, especially during the COVID-19 pandemic. However, it is unknown whether D1/D8 gemcitabine imparts an improvement in efficacy compared to D1 alone. Our objective was to compare efficacy and toxicity of carboplatin and gemcitabine D1/D8 (CG-D1/8) with a modified D1 regimen (CG-D1). Methods: A retrospective single-institution cohort study was performed in women with recurrent PSOC treated with carboplatin, gemcitabine +/-bevacizumab from 2009-2020. Data was analyzed by intention to treat comparing women who received CG-D1/8 vs CG-D1. Data was also analyzed by 3 groups: CG-D1/8 vs CG-D1/8 but dropped D8 vs CG-D1. The primary endpoint was response rate (RR), defined as complete or partial response at 6 cycles or maximum cycles if <6. Secondary outcomes included PFS, overall survival (OS), toxicity, Neulasta use and dose reduction. Results: Of 200 patients, 26% completed CGD1/ D8, 21.5% started CG-D1/D8 but dropped D8, and 52.5% received CG-D1. There were no significant differences in age, race, or ECOG between cohorts. Among CG-D1/D8, 45.3% dropped D8 primarily due to neutropenia (51.2%) or thrombocytopenia (30.2%). The RR at 6 cycles was 68.7% for CG-D1/8 completed, 70.7% for CG-D1/8 dropped D8, and 69.3% for CG-D1 (p=0.97). The median PFS was 13.1, 12.1 and 12.4 months for CG-D1/8 completed, CG-D1/8 dropped D8, and CG-D1, respectively (p=0.29). Similarly, median OS was 28.2, 33.5 and 34.3 months for the above groups respectively (p=0.42). While there was no difference in concurrent bevacizumab use for CG-D1/8 and CG-D1 (34.7% vs 29.5%, p=0.43), among the CG-D1/8 patients, a significantly higher proportion of patients who dropped D8 received bevacizumab (51.2% vs 21.2%, p=0.006). Table 1 lists secondary outcomes. Conclusions: There was no significant difference in RR, PFS or OS among women with PSOC receiving CG-D1/8 vs CG-D1, regardless of whether D8 was dropped. CG-D1/8 was associated with significantly greater hematologic toxicity. These findings suggest a modified D1 regimen may be a suitable alternative to standard CG-D1/8 treatment and warrant prospective validation.

Analysis and Research on the Characteristics of COVID-19 Epidemic in Urban Village and Its Prevention and Control Strategies in Primary Care Institutions

Background: For a period of time, the outbreak of the COVID-19 outbreak in many urban villages in our country had caused concern. The dense and complex population structure of urban villages, with their inter-regional mobility, posed a challenge to the prevention and control of the epidemic. Objective: Urban village areasare more prone to regional outbreaks of infectious diseases because of their spatial environment, demographic characteristics, cross-regional mobility and the characteristics of residents' medical treatment behavior. The purpose of this study was tounderstand the characteristics of the COVID-19 epidemic situation in urban villages and the current situation and difficulties of primary care institutions in carrying out COVID-19 epidemic prevention and control measures, in order to provide references for primary care institutions to deal with normalized prevention and control, social dynamic clearing work and future infectious disease prevention and control. Methods: By using public opinion analysis, literature retrieval, online interviews with epidemic prevention and control personnel and experts in urban village, the epidemic situation, prevention and control status of urban village were summarized, and the existing weak links and important loopholes were analyzed. Results: Based on the relevant information, a total of six points of concern were extracted: (1) The number of mapping and screening objects was large, which was the focus and difficulty of epidemic prevention and control work in urban villages.(2) There was not strict closed-loop management lead to virus carriers who were not timely controlled, which caused a risk of spreading the epidemic.(3) The prevention and control of nosocomial infection in primary care institutions was not in place.(4)There were loopholes in the inspection of close contacts in the principle of territorial management;close contacts who did not live and work in the same administrative area but only screened in their living places, which may lead to the spread of the epidemic in workplaces where secondary close contacts may be at risk of infection were not screened in a timely manner.(5) Overload had become the norm, highlighting the large gap in primary health care manpower.(6) During the normalization of epidemic prevention and control, residents were paralyzed and careless, and the phenomenon of not wearing masks in public places and crowd gathering was common. Health education still needs to be strengthened and emphasized that residents were the first responsible for their own health. Conclusion: Primary care providers played an important role in the prevention and control of COVID-19 in urban village by undertaking community management, outpatient treatment, public health services, health education, vaccination, quarantine hotel stationing, joint prevention and control, etc. It was recommended that additional fever sentinel clinics be set up for early detection and isolation to avoid further spread of the epidemic, rental houses be requisitioned to meet the demand for isolated medical observation, primary care institutions be strengthened for hospitalization and prevention, green relief channels be opened to protect special groups from medical treatment, volunteers be organized to reinforce primary care institutions, and health education emphasized that residents were the first to be responsible for maintaining their own health and raised personal awareness of the risk of COVID-19 prevention and control. Copyright © 2022 by the Chinese General Practice.

“Smoke Detector” of Human Diseases for Environmental Aerosol Exposure

Air consists of various different pollutants (both biological and non-biological). COVID-19 pandemic further threatens the air safety. Aerosol exposure causes many diseases including asthma, respiratory infections and death. Using protein biomarker for early diagnosis often fails due to its lower level at the very beginning of a disease. On another front, different technologies were attempted for realtime monitoring of air toxicity. Nonetheless, many aerosol exposures occur silently without any knowledge due to limitation of available analytical methods. Exhaled breath has emerged as a promising non-invasive sample for disease diagnosis, including cancer and diabetes. Most recently, it was shown that rats emitted distinctive profile of volatile organic compounds (VOCs) within minutes when exposed to different air pollutants including ozone and endotoxin. During the pandemic times, breath-borne VOC was also used to rapidly screen COVID-19. Pollutant exposure could result in changes in metabolism, thus releasing different patterns of VOCs via breath within very short time. Close monitoring of exhaled biomarker profile could spot the early signs of a disease, thus offering an earlier warning. Sensor array and machine learning together can lend a great hand toward such an objective. This mini review is undertaken to share such endeavors and inspire further innovations. What is the most favorite and original chemistry developed in your research group?. Realtime aerosol detection and toxicity analysis, as well as breath biology, including its application in rapid COVID-19 screening. How do you get into this specific field? Could you please share some experiences with our readers?. Motivation and problem driven curiosity are key elements for performing impactful and milestone work. Additionally, being ambitious in leading plays another critical role in scientific exploration, excellence and influence. These research directions are the results of the ambition for solving important problems facing mankind and society. Of course, perseverance is another key driver toward pioneering discovery and effort. How do you supervise your students?. Students are the key part for research discoveries. Thus, communication and discussion are very important both in education and performing influential work. It is critically important to find a rewarding and innovative project to motivate them to move forward with a plan. Good project can not only produce high impact data, but also help students develop essential problem solving skills and thinking. In return, this will cycle back to performing the impactful work. Eventually, students benefit greatly from the process and become very capable and confident. What is the most important personality for scientific research?. Scientific devotion and ambition in tackling key problems facing mankind. What are your hobbies? What's your favorite book(s)?. My hobbies include listening to music, reading English books & news, thinking, occasionally watching movies made from Kungfu novels and most recently enjoy running. Who influences you mostly in your life?. During childhood, my grandma influenced me most. Now, it seems challenges we are facing take my most time. How do you keep balance between research and family?. It takes some compromise to find a balance between work and family. They are equally important. During different age periods, you will feel a different need to balance between them. Nonetheless, communication and understanding play an important role in solving balance problem. Another useful tip is to improve work efficiency and to avoid unnecessary things, thus saving more time for family and impactful work. In addition, having a well-planned to-do-list is useful to the balance too. Could you please give us some advices on improving Chinese Journal of Chemistry?. It helps by rotating 20% of the editorial board, i.e., every three years, speeding up the review process, placing the novelty on the first priority, and conducting double blind review. Top high quality paper should be a must prin iple regardless of the manuscript origin. In addition, increasing the publicity of journal, e.g., using social media not just domestic, but also those overseas, also makes a difference. © 2022 SIOC, CAS, Shanghai, & WILEY-VCH GmbH.

SARS-CoV-2 Remained Airborne for a Prolonged Time in a Lockdown Confined Space

Airborne transmission of COVID-19 plays an important role for the pandemic. However, nucleic acid based evidence of direct association of COVID-19 with environmental contamination is lacking. Here, we investigated a COVID-19 outbreak with two fast food employees infected, in which a traveler despite of a 14-day quarantine turned positive after check in with a hotel, using environmental SARS-CoV-2 sampling, epidemiological tracing, viral RNA sequence as well as surveillance method. Out of 25 positive environmental air and surface swab samples (N = 237) collected, SARS-CoV-2 was found to have remained airborne (5640–7840 RNA copies m–3 ) for more than 4 days in a female washroom. After aging for 5 days in the air, no viable virus was detected. The traveler did not have any contacts with the two employees;however, genome sequencing showed that SARS-CoV-2 variants from three patients and two environmental surface samples belonged to 20B viral clade, sharing a nucleic acid identity of more than 99.9%. We concluded that the outbreak was triggered by SARS-CoV-2 contaminated environments, where the employees inhaled the virus from the air or touching facility surfaces where the traveler did not have any physical contacts with. © The Author(s).

A Robot Assisted High-flow Portable Cyclone Sampler for Bacterial and SARS-CoV-2 Aerosols

Airborne transmission of infectious diseases attracts great attention since the COVID-19 pandemic. Yet, there has been an intense dispute about aerosol transmission of the disease, which is largely due to lack of qualified instruments for studying the subject. Air sampling plays a critical role in all air pollution related study, and particularly critical for airborne pathogen detection. Here, we designed and evaluated a portable and high volume (400 L min-1) cyclone sampler named as Yao-CSpler using aerosolized Polystyrene (PS) uniform microspheres, Bacillus subtilis var. niger, Pseudomonas fluorescens, and both indoor and outdoor air particles. The experimental cutoff size of the Yao-CSpler was demonstrated to be 0.58 m (while the calculated theoretical value is 1.84 m), and the sampler has shown stable microbial collection performances for bacteria, fungi, and even viruses. The sampler had a physical collection efficiency of close 100% for particles of larger than 1 m. Jet-to-liquid distance and sampling duration were shown to substantially influence the sampler performance. Given the same sampling duration, the performances of the Yao-CSpler were significantly higher than those of the traditional BioSampler (SKC Inc.) in terms of samples' bacterial diversity. The developed sampler coupled with a robot has been successfully applied to sampling airborne SARS-CoV-2 in both Wuhan and Beijing during the COVID-19 outbreaks. With a high sampling flow, the Yao-CSpler was shown to be able to collect the SARS-CoV-2 with a detectable concentration level down to 9-219 viruses m-3 in clinical settings housing COVID-19 patients. Further more efficient bioaerosol sampler, which is able to rapidly capture low level pathogenic agents, is urgently required to better understand and confront airborne transmission of infectious diseases.

Utility of a novel platform for performing prostate biopsy-results of the first 750 patients using a Free hand ultrasound guided local anaesthetic transperineal prostate (LATP) technology

Introduction & Objective: Prostate Biopsy remains the gold standard for histological confirmation of prostate cancer. The near exponential increase in the need for biopsies, in selected men, has ushered an evolving need for improving detection rates while reducing side effects. Diagnostic accuracy and infection complication rates remain obstacles in transrectal prostate biopsy. PrecisionPoint is a disposable, low cost device which enables transperineal biopsy in the outpatient setting under local anaesthetic. We present data from a predominantly nurse-performed LATP service using PrecisionPoint, which was newly started in July 2019. Initial indications were;repeat biopsy, anterior lesions, and active surveillance patients. Service was expanded in March 2020 to all prostate pathway patients following national COVID guidance. Methods: All patients underwent prebiopsy MRI and dedicated image-review meetings. Biopsies were performed in PIRADS 3-5, or PSAD >0.15. PIRADS 3-5 lesions were targeted with ≥3 cores (sent separately). Systematic Ginsburg protocol biopsies were also performed (each zone sent separately). Tamsulosin was started for BOO patients. No antibiotics were used unless immunocompromised or previous sepsis. A prospective database at point of care was created detailing patient information, MRI and biopsy characteristics. Patient Reported Outcome Measures (PROMs) are collected. Histology and complications are also reported. Results: 750 consecutive patients analysed. Detection of significant cancer (Gl ≥3 + 4) in PIRAD1-2, 3, 4, 5 groups was 25%, 40%, 59%, 92% respectively. Systematic biopsy alone detected significant cancer in 36%, systematic plus targeted achieved 63%. Of AS patients;40% with Gl3 + 3 were upgraded, and 49% with Gl3 + 4 were upgraded to Gl ≥4 + 3. 5 experienced vasovagal episodes. Only 5 patients were readmitted (0.6%): 2 UTI, 2 AUR, 1 urosepsis. PROMs demonstrated majority favourable results regarding pain (98%), discomfort (97%), embarrassment (96%) and further biopsies (89%). Conclusions: Adoption of this new technology into an integrated prostate cancer diagnostic pathway has enabled us to set up a safe, effective, antibiotic free LATP biopsy service in the outpatient setting. Data shows high cancer detection rates and low complication rates. PROMs data suggests this iswell tolerated by patients.

Antibiotic free local anaesthetic transperineal prostate (LATP) biopsies: A review of the first 750 cases

INTRODUCTION AND OBJECTIVE: A LATP service using PrecisionPoint™ was newly started in July 2019, with procedures performed by both surgeon and nurse practitioners. Initial indications were: repeat biopsy, anterior prostate lesions, and Active Surveillance patients. Service was expanded in March 2020 to all prostate pathway patients according to British Association of Urology COVID guidance. METHODS: All patients underwent prebiopsy MRI and dedicated image-review meetings. Biopsies were performed in PIRADS 3-5, or PSAD>0.15. Systematic Ginsburg protocol biopsies were performed for all patients (each zone sent separately), and PIRADS 3-5 lesions were targeted with ≥3 cores (also sent separately). Alpha-blockers were started for patients with Bladder Outlet Obstruction. No antibiotics were used unless patients were immunocompromised or had a previous history of urinary sepsis. A prospective database at point of care was created detailing patient demographics, MRI and biopsy characteristics. Patient Reported Outcome Measures (PROMs) are collected. Histology and complications are also reported. RESULTS: 750 consecutive patients are analysed. Detection of clinically significant prostate cancer (Gl≥3+4) in PIRADS 1-2, 3, 4, 5 groups was 25%, 40%, 59%, 92% respectively. Systematic biopsy alone detected clinically significant cancer in 36%, whereas systematic plus targeted biopsy achieved 63%. Of Active Surveillance patients;40% with Gl 3+3 were upgraded, and 49% with Gl3+4 were upgraded to Gl≥4+3. n=5 (0.6%) experienced vasovagal episodes causing delayed discharge. Only n=5 patients were readmitted (0.6%): 2 urinary tract infection, 2 acute urinary retention, 1 urinary sepsis. PROMs demonstrated majority favourable results regarding pain (98%), discomfort (97%), embarrassment (96%) and further repeat biopsies (89%). CONCLUSIONS: We have set up a safe, effective, antibiotic free LATP biopsy service, with high cancer detection rates and low complication rates. PROMs data suggests this is well tolerated by patients.

Clinical characteristics of COVID-19 patients in three consecutive generations of spread in Zhejiang, China.

OBJECTIVES: The aim was to determine the clinical characteristics of COVID-19 patients because the SARS-CoV-2 virus continues to circulate in the population. METHODS: This is a retrospective, multicentre, cohort study. Adult COVID-19 cases from four hospitals in Zhejiang were enrolled and clustered into three groups based on epidemiological history. First-generation patients had a travel history to Hubei within 14 days before disease onset; second-generation patients had a contact history with first-generation patients; third-generation patients had a contact history with second-generation patients. Demographic, clinical characteristics, clinical outcomes and duration of viral shedding were analysed. RESULTS: A total of 171 patients were enrolled, with 83, 44 and 44 patients in the first-, second-, and third-generation, respectively. Compared with the first and second generations, third-generation patients were older (61.3 vs. 48.3 and 44.0 years, p < 0.001) and had more coexisting conditions (56.8% vs. 36.1% and 27.3%, p 0.013). At 7 ± 1 days from illness onset, third-generation patients had lower lymphocyte (0.6 vs. 0.8 and 0.8 × 109/L, p 0.007), higher C-reactive protein (29.7 vs. 17.1 and 13.8 mg/L, p 0.018) and D-dimer (1066 vs. 412.5 and 549 µg/L, p 0.002) and more lesions involving the pulmonary lobes (lobes ≥5, 81.8% vs. 53.0% and 34.1%, p < 0.001). The proportions of third-generation patients developing severe illness (72.7% vs. 32.5% and 27.3%, p < 0.001), critical illness (38.6% vs. 10.8% and 6.8%, p < 0.001) and receiving endotracheal intubation (20.5% vs. 3.6% and 2.3%, p 0.002) were higher than in the other two groups. DISCUSSION: Third-generation patients were older, had more underlying comorbidities and had a higher proportion of severe or critical illness than first- and second-generation patients.

Identifiability as an “Antidote”: Exploring Emotional Contagion and the Role of Anonymity in Twitter Discussions on Misinformation

Misinformation carries both distorted facts and sophisticated emotional signals. Comparing to facts that could be labeled as true or false, we are more concerned about contaminative negative emotions transferring digitally among users. In this study, we explored an emotional contagion effect among misinformation discussion participants on Twitter. We analyzed the sentiment of 573 tweets in 192 discussion threads. Our result revealed that highly emotional tweets do not have a universal effect on the online discussions, but it affects those individuals with limited social and personal identity cues (i.e., being anonymous). We found that anonymous members of the online discussion are more susceptible to emotional contagions than those are not. We also suggest coping strategies that protect social media users’ emotional well-being during the era COVID-19. © 2021, Springer Nature Switzerland AG.

Post-Traumatic Stress Disorder Among Emergency Department Clinicians During the Pandemic

Study Objective: The DSM-5 defines post-traumatic stress disorder (PTSD) as the development of certain characteristic symptoms after direct, witnessed, or secondhand “exposure to actual or threatened death, serious injury, or sexual violence.” The COVID-19 pandemic has been compared to the 2003 SARS outbreak;health care workers (HCWs) during that crisis experienced increased levels of emotional distress. As of March 2021, there have been over 830,000 cases of COVID-19 and 24,000 mortalities in New Jersey (NJ). Our study aimed to identify the point prevalence of PTSD and sub-threshold PTSD in HCWs across NJ during the second wave of the pandemic. Methods: We conducted a prospective survey study that was distributed electronically to physicians (attendings, fellows, and residents) and mid-level practitioners (MLPs) working in emergency departments across NJ from December 2020 – March 2021 using a secure, online survey platform. Results: All collected participant demographics are shown by training level in Table 1. There are several provisional diagnostic determinations of PTSD currently in use (Table 2). For continuous total severity score, the mean score and standard deviation (SD) for attending physicians was 13.9 (12.6), for resident/fellow physicians it was 15.4 (18.2), and for MLPs it was 20.4 (14.9), causing a statistically significant difference between the groups (p=0.01). Following the DSM-5 criteria, a total of 27 individuals were diagnosed with PTSD, where a significantly high proportion of those were MLPs (n (%) = 20 (25);p=0.02). DSM-5 criteria B-E (Table 2) is used to evaluate subthreshold PTSD. Regardless of whether two or three criteria were used for diagnosis, the proportion met was greatest for the MLPs, with criterion D being significantly associated with training level (p=0.01). Discussion: Physician burnout is well documented in the U.S. Current second-year emergency medicine residents had the highest contiguous severity score, most likely because their intern year was completely consumed by the COVID-19 crisis. The pandemic put a dent in the movement for physician wellness. Attending physicians in teaching hospitals are responsible for, in addition to patient care, the training of residents. The burden of navigating a mentorship role while managing the high volume of critical ill patients suffering from a novel disease can't be ignored. MLPs, along with their physician colleagues, experienced shortages in PPE, redeployment into other subspecialists, furlough and/or termination from their positions, and COVID morbidity. Conclusions: The COVID-19 pandemic has caused significant psychological trauma for HCWs. Regardless of training level, physicians and mid-level practitioners report symptoms suggestive of PTSD and sub-PTSD. MLPs were particularly affected by the trauma of the novel coronavirus and more research must be done to fully elucidate why this particular group of providers has been so negatively impacted. [Formula presented]

Antibiotic free Local Anaesthetic Transperineal Prostate (LATP) biopsies: A review of the first 750 cases

Introduction: A predominantly nurse-performed LATP service using PrecisionPoint was newly started in July 2019. Initial indications were repeat biopsy, anterior lesions, and AS patients. Service was expanded in March 2020 to all prostate pathway patients according to BAUS COVID guidance. Methods: All patients underwent prebiopsy MRI and dedicated image-review meetings. Biopsies were performed in PIRADS 3-5, or PSAD >0.15. PIRADS 3-5 lesions were targeted with 3 cores (sent separately). Systematic Ginsburg protocol biopsies were also performed (each zone sent separately). Tamsulosin was started for BOO patients. No antibiotics were used unless immunocompromised or previous sepsis. A prospective database at point of care was created detailing patient information, MRI and biopsy characteristics. Patient Reported Outcome Measures (PROMs) are collected. Histology and complications are also reported. Results: 750 consecutive patients analysed. Detection of significant cancer (Gl3+4) in PIRAD1-2, 3, 4, 5 groups was 25%, 40%, 59%, 92% respectively. Systematic biopsy alone detected significant cancer in 36%, systematic plus targeted achieved 63%. Of AS patients;40% with Gl3+3 were upgraded, and 49% with Gl3+4 were upgraded to Gl4+3. 5 experienced vasovagal episodes. Only 5 patients were readmitted (0.6%): 2 UTI, 2 AUR, 1 urosepsis. PROMs demonstrated majority favourable results regarding pain (98%), discomfort (97%), embarrassment (96%) and further repeat biopsies (89%). Conclusion: We have set up a safe, effective, antibiotic free LATP biopsy service, with high cancer detection rates and low complication rates. PROMs data suggests this is well tolerated by patients.

Transmission of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) through infant feeding and early care practices: A systematic review.

BACKGROUND: Perinatal practices such as breast-feeding, kangaroo mother care, rooming-in, and delayed cord clamping have varied by institution during the COVID-19 pandemic. The goal of this systematic review was to examine the success of different practices in preventing viral transmission between SARS-CoV-2 positive mothers and their infants. METHODS: Electronic searches were performed in the Ovid MEDLINE, Ovid Embase, Cochrane Library, EBSCOhost CINAHL Plus, Web of Science, and Scopus databases. Studies involving pregnant or breastfeeding patients who tested positive for SARS-CoV-2 by RT-PCR were included. Infants tested within 48 hours of birth who had two tests before hospital discharge were included. Infants older than one week with a single test were also included. RESULTS: Twenty eight studies were included. In the aggregated data, among 190 breastfeeding infants, 22 tested positive for SARS-CoV-2 (11.5%), while 4 of 152 (2.63%) among bottle-fed (Fisher's exact test p = 0.0006). The positivity rates for roomed in infants (20/103, 19.4%) were significantly higher than those isolated (5/300, 1.67%) (P < 0.0001). There was no significant difference in positivity rate among infants who received kangaroo care (25%vs 9%, p = 0.2170), or delayed cord clamping (3.62%vs 0.9%, p = 0.1116). CONCLUSIONS: Lack of robust studies involving large patient population does not allow meaningful conclusions from this systematic review. Aggregated data showed increased positivity rates of SARS-CoV-2 among infants who were breast fed and roomed-in. There were no differences in SARS-CoV-2 positivity rates in infants received skin to skin care or delayed cord clamping.

Prevention and control of novel coronavirus infections in primary care institutions at early stage of the epidemic: a qualitative study

Objective: To analyze the status of prevention and control of COVID-19 in primary care institutions at the early stage of the epidemic. Methods: Thirty healthcare professionals from various places of China were recruited in the study from 6thto 16th February 2020 through WeChat platform advertising and by purposive sampling method. They were general practitioners (GPs), administrators, and other specialists, all of whom were involved in the prevention and control of COVID-19. Personal interview and focus group discussion were conducted online. The topic guide was as follows: (1) Introduction of the work that primary healthcare professionals carried out during the outbreak of COVID-19. (2) Difficulties and challenges that healthcare professionals encountered. (3) Opinions on the prevention and control of COVID-19. (4) Advices on future outbreak of similar epidemics or disease. NVivo 12 software system was used to code and classify the interview content, and thematic framework analysis was used to sort out and analyze the data and extract the interview themes. Results: Six themes were extracted: (1) The community hospital leaders led the work in time but job distribution and prevention procedures were insufficient;and the workload of GPs was heavy. (2) Primary care settings had carried out pre-screening and triage;while outpatient clinic continued to provide health care service for local residents, especially stressing online service and consultation to reduce the population mobility. (3) GPs should make full use of technical advantages and participate in joint prevention and control. (4) GPs offered various health education to residents to improve their awareness of self-protection. (5) GPs lacked professional skills and needed more related training, while the current training were still insufficient. (6) There were not enough supplies and GPs had increasing worries about the infection risks. Conclusions: GPs play an important role in effectively curbing the spread of the epidemic. It is suggested that the setting of triage and fever clinic in primary care institutions need to be readjusted;and the training of prevention and control knowledge and skill for GPs need to be strengthened in the future. © 2021 Chinese Medical Association

Prediction of potential therapeutic drugs against SARS-CoV-2 by using Connectivity Map based on transcriptome data.

OBJECTIVE: Transcriptome data related to severe acute respiratory syndrome-related coronavirus 2 (a novel coronavirus discovered in 2019, SARS-CoV-2) in GEO database were downloaded. Based on the data, influence of SARS-CoV-2 on human cells was analyzed and potential therapeutic compounds against the SARS-CoV-2 were screened. MATERIALS AND METHODS: R package "DESeq2" was used for differential gene analysis on the data of cells infected or non-infected with SARS-CoV-2. The "ClusterProfiler" package was used for GO functional annotation and KEGG pathway enrichment analysis of the differentially expressed genes (DEGs). A protein-protein interaction (PPI) network of the DEGs was constructed through STRING website, and the key subset in the PPI network was identified after visualization by Cytoscape software. Connectivity Map (CMap) database was used to screen known compounds that caused genomic change reverse to that caused by SARS-CoV-2. RESULTS: By intersecting DEGs in two datasets, a total of 145 DEGs were screened out, among which 136 genes were upregulated and 9 genes were downregulated in SARS-CoV-2-infected cells. Functional enrichment analyses revealed that these genes were mainly associated with the pathways involved in viral infection, inflammatory response, and immunity. The CMap research found that there were three compounds with a median_tau_score less than -90, namely triptolide, tivozanib and daunorubicin. CONCLUSIONS: SARS-CoV-2 can cause abnormal changes in a large number of molecules and related signaling pathways in human cells, among which IL-17 and TNF signaling pathways may play a key role in pathogenic process of SARS-CoV-2. Here, three compounds that may be effective for the treatment of SARS-CoV-2 were screened, which would provide new options for improving treatment of patients infected with SARS-CoV-2.

[Application and thinking of health standards related to public health in prevention and control of coronavirus disease 2019].

Objective: To systematically analyze the basic characteristics and contents of the current health standards for infectious disease, environmental health, school health and disinfection in the context of COVID-19 prevention and control, and provide support for the further optimization of epidemic prevention and control guidelines and reference for the revision and improvement of related health standards. Methods: Public health standards used in COVID-19 prevention and control were selected for a systematic comparison with "The Plan of COVID19 Prevention and Control (the 6(t)h Edition)" and other epidemic prevention and control guidelines from the perspectives of application scope and technical elements. Results: The current standards of public health are with scientificity, timeliness and feasibility. The application scope and technical elements of the current public health standards basically meet the needs of the prevention and control of COVID-19 epidemic, but the public health standardization system still needs improvement, and some public health standards need to be revised. Conclusions: The implementation of current public health standards can provide strong technical support for the prevention and control of COVID-19 epidemic. The experience obtained from COVID-19 epidemic prevention and control might promote the further improvement of the health standardization system.

The Existing Problems and Suggestions of Primary Health Care Settings in Normalization of Epidemic Prevention and Control Infection in Novel Coronavirus

In the prevention and control of infectious diseases in novel coronavirus, the primary health care settings played an important role in community epidemic prevention and control, which was the most effective defense line for external import and internal non-proliferation.Faced with the local outbreak or regional epidemic of novel coronavirus infection in the present and even in the future for a long time, primary health care settings need to normalize the epidemic prevention work and make up for the shortcomings in the prevention and control of the major epidemic in time, including: the environmental construction was not standardized, the emergency materials reserve was insufficient, the system construction was a mere formality, and the ability to build primary emergency teams was insufficient.In the future, it is suggested to strengthen the standardization of primary health care in terms of site environment, system improvement, team building, and primary emergency response capability, and attach importance to the labor value of primary health care professionals. Copyright © 2020 by the Chinese General Practice.