Nutritional risk and a high NRS2002 score are closely related to disease progression and poor prognosis in patients with COVID-19.

Background: Organism can lead to excessive nutrient consumption in the infected state and increase nutritional risk, which is detrimental to the control of the infection and can further aggravate the disease. Objectives: To investigate the impact of nutritional risk and the NRS2002 score on disease progression and prognosis in patients with COVID-19. Methods: This was a retrospective cohort study including 1,228 COVID-19 patients, who were divided into a with-nutritional risk group (patients with NRS2002 score ≥ 3) and a without-nutritional risk group (patients with NRS2002 score < 3) according to the NRS2002 score at admission. The differences in clinical and outcome data between the two groups were compared, and the relationship between the NRS2002 score and the disease progression and prognosis of COVID-19 patients was assessed. Results: Of 1,228 COVID-19 patients, including 44 critical illness patients and 1,184 non-critical illness patients, the rate of harboring nutritional risk was 7.90%. Compared with those in the without-nutritional risk group, patients in the with-nutritional risk group had a significantly longer coronavirus negative conversion time, significantly lower serum albumin (ALB), total serum protein (TP) and hemoglobin (HGB) at admission, discharge or 2 weeks, a significantly greater proportion with 3 or more comorbidities, and a significantly higher rate of critical illness and mortality (all p < 0.001). Multiple regression analysis showed that nutritional risk, NRS2002 score and ALB at admission were risk factors for disease severity. In addition, nutritional risk, NRS2002 score and TP at admission were risk factors for prognosis. The NRS2002 score showed the best utility for predicting critical illness and death in COVID-19 patients. Conclusion: Nutritional risk and a high NRS2002 score are closely related to disease progression and poor prognosis in COVID-19 patients. For patients with NRS2002 score > 0.5, early intervention of malnutrition is needed to reduce the occurrence of critical disease. Additionally, for patients with NRS2002 score > 5.5, continuous nutritional support therapy is needs to reduce mortality and improve prognosis.Clinical Trial registration: [https://www.chictr.org.cn/historyversionpub.aspx?regno=ChiCTR2000034563], identifier [Chinese Clinical Trial Register ChiCTR2000034563].

International students' collective resilience in crisis: Sense of community reduced anxiety via social contact and social support during lockdown.

Objectives: The role of community in individuals' well-being has been extensively examined in the Western context. However, little is known about how the host community is related to sojourners' well-being in a crisis in an Asian context. The current study aims at exploring international students' sense of community in the Chinese context under the direct threat of a global health crisis. Methods: Using a cross-sectional sample of 102 international students staying in Wuhan during the 76-day lockdown at the earliest stage of the COVID-19 pandemic, the current study explored the relationship between international students' sense of community and anxiety, and the mediating role of social contact, social support from three key sources in the host community (host university, international students, and Chinese friends). Results: Results showed that participants' stronger sense of community indirectly reduced anxiety via the role of sources of contact and support from the host community. Conclusions: This study provided further evidence to support the nurturance of the sense of community in community resilience and provided implications on how the host community can help to enhance sojourners' psychological well-being in a global crisis.

Fear during pandemic promoted holistic cognitive style: The moderating role of uncertainty.

The present study explored the link between fear and holistic cognitive style and the moderating role of uncertainty. We examined these effects in a real-life situation: the long-term, global COVID-19 pandemic, which provided a natural context of fear and uncertainty. The current study comprises three studies recruiting N = 1,310 participants. Study 1 compared the link between fear and holistic style in the United States (a relatively uncertain situation presented by the COVID-19 pandemic) and China (a pandemic situation with relative certainty) in the early days of the pandemic. Study 2 examined the moderation effect of uncertainty in the relationship between fear and holistic style by manipulating participants into a fearful (vs. control) condition. Study 3 employed a longitudinal design to demonstrate the effect of fear-related emotions on holistic style change over a 3-month period. Across three studies, the moderation effect of uncertainty in the relationship between fear-related emotions and holistic style during the COVID-19 pandemic was consistently observed. In sum, this study provided an ecological and explanatory mechanism for understanding the impact of individuals' fear on holistic cognitive style. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sensing of cytoplasmic chromatin by cGAS activates innate immune response in SARS-CoV-2 infection.

The global coronavirus disease 2019 (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a positive-sense RNA virus. How the host immune system senses and responds to SARS-CoV-2 infection remain largely unresolved. Here, we report that SARS-CoV-2 infection activates the innate immune response through the cytosolic DNA sensing cGAS-STING pathway. SARS-CoV-2 infection induces the cellular level of 2'3'-cGAMP associated with STING activation. cGAS recognizes chromatin DNA shuttled from the nucleus as a result of cell-to-cell fusion upon SARS-CoV-2 infection. We further demonstrate that the expression of spike protein from SARS-CoV-2 and ACE2 from host cells is sufficient to trigger cytoplasmic chromatin upon cell fusion. Furthermore, cytoplasmic chromatin-cGAS-STING pathway, but not MAVS-mediated viral RNA sensing pathway, contributes to interferon and pro-inflammatory gene expression upon cell fusion. Finally, we show that cGAS is required for host antiviral responses against SARS-CoV-2, and a STING-activating compound potently inhibits viral replication. Together, our study reported a previously unappreciated mechanism by which the host innate immune system responds to SARS-CoV-2 infection, mediated by cytoplasmic chromatin from the infected cells. Targeting the cytoplasmic chromatin-cGAS-STING pathway may offer novel therapeutic opportunities in treating COVID-19. In addition, these findings extend our knowledge in host defense against viral infection by showing that host cells' self-nucleic acids can be employed as a "danger signal" to alarm the immune system.

The Strengthening Mechanism of the Relationship between Social Work and Public Health under COVID-19 in China.

Social work and public health have always shared a common mission and vision in promoting human health. However, existing research tends to view social work and public health as two separate fields at both practice and policy levels, and these studies have largely neglected the consideration of how to integrate public health and social work. In the context of the COVID-19 epidemic, the link between the two has been strengthened and health social work has been given more importance. The question addressed in this article is through what mechanisms or practices the social work profession can strengthen its professional status and engage in interprofessional collaboration. Based on key informant interviews and case studies (one community and two cabin Hospitals), this study points out that three legitimacy mechanisms are needed: operationalizing policy, extending value, and completing justification. Furthermore, the future and possible limitations in relation to the development of health social work in China are discussed and specific recommendations are provided. Health social work needs to conduct practices and summarize its experiences and methods, to create a more friendly political environment by translating its results into policies that are conducive to the development of health social work through a political agenda. It needs to improve upon its practical abilities and methodologies, as well as professional education relating to professional values and ethics, in addition to identifying the deeper social needs of residents and discovering new, undeveloped areas of service. Moreover, because long-term change is difficult to justify due to China's policy agendas, the question of whether the professional status of health social work in the post-epidemic context can be improved is something that needs to be further explored in future studies.

Effect of Salt Substitution on Cardiovascular Events and Death.

BACKGROUND: Salt substitutes with reduced sodium levels and increased potassium levels have been shown to lower blood pressure, but their effects on cardiovascular and safety outcomes are uncertain. METHODS: We conducted an open-label, cluster-randomized trial involving persons from 600 villages in rural China. The participants had a history of stroke or were 60 years of age or older and had high blood pressure. The villages were randomly assigned in a 1:1 ratio to the intervention group, in which the participants used a salt substitute (75% sodium chloride and 25% potassium chloride by mass), or to the control group, in which the participants continued to use regular salt (100% sodium chloride). The primary outcome was stroke, the secondary outcomes were major adverse cardiovascular events and death from any cause, and the safety outcome was clinical hyperkalemia. RESULTS: A total of 20,995 persons were enrolled in the trial. The mean age of the participants was 65.4 years, and 49.5% were female, 72.6% had a history of stroke, and 88.4% a history of hypertension. The mean duration of follow-up was 4.74 years. The rate of stroke was lower with the salt substitute than with regular salt (29.14 events vs. 33.65 events per 1000 person-years; rate ratio, 0.86; 95% confidence interval [CI], 0.77 to 0.96; P = 0.006), as were the rates of major cardiovascular events (49.09 events vs. 56.29 events per 1000 person-years; rate ratio, 0.87; 95% CI, 0.80 to 0.94; P<0.001) and death (39.28 events vs. 44.61 events per 1000 person-years; rate ratio, 0.88; 95% CI, 0.82 to 0.95; P<0.001). The rate of serious adverse events attributed to hyperkalemia was not significantly higher with the salt substitute than with regular salt (3.35 events vs. 3.30 events per 1000 person-years; rate ratio, 1.04; 95% CI, 0.80 to 1.37; P = 0.76). CONCLUSIONS: Among persons who had a history of stroke or were 60 years of age or older and had high blood pressure, the rates of stroke, major cardiovascular events, and death from any cause were lower with the salt substitute than with regular salt. (Funded by the National Health and Medical Research Council of Australia; SSaSS ClinicalTrials.gov number, NCT02092090.).

Baidu Index and COVID-19 Epidemic Forecast: Evidence From China.

With the global spread of the Coronavirus epidemic, search engine data can be a practical tool for decision-makers to understand the epidemic's trends. This article uses trend analysis data from the Baidu search engine, the most widely used in China, to analyze the public's attention to the epidemic and the demand for N95 masks and other anti-epidemic materials and information. This kind of analysis has become an important part of information epidemiology. We have analyzed the use of the keywords "Coronavirus epidemic," "N95 mask," and "Wuhan epidemic" to judge whether the introduction of real-time search data has improved the efficiency of the Coronavirus epidemic prediction model. In general, the introduction of the Baidu index, whether in-sample or out-of-sample, significantly improves the prediction efficiency of the model.

Efficacy and safety of Xiyanping injection in the treatment of COVID-19: A multicenter, prospective, open-label and randomized controlled trial.

Xiyanping (XYP) is a Chinese herbal medicine used in the clinic to treat respiratory infection and pneumonia. Recent evidence identified XYP as a potential inhibitor of severe acute respiratory syndrome coronavirus 2, implying XYP as a possible treatment for the coronavirus disease 2019 (COVID-19). Here, we conducted a prospective, multicenter, open-label and randomized controlled trial to evaluate the safety and effectiveness of XYP injection in patients with mild to moderate COVID-19. We consecutively recruited 130 COVID-19 patients with mild to moderate symptoms from five study sites, and randomized them in 1:1 ratio to receive XYP injection in combination with standard therapy or receive standard supportive therapy alone. We found that XYP injection significantly reduced the time to cough relief, fever resolution and virus clearance. Less patients receiving XYP injection experienced disease progression to the severe stage during the treatment process. No severe adverse events were reported during the study. Taken together, XYP injection is safe and effective in improving the recovery of patients with mild to moderate COVID-19. However, further studies are warranted to evaluate the efficacy of XYP in an expanded cohort comprising COVID-19 patients at different disease stages.

Health Behaviors of Higher Education Students from 7 Countries: Poorer Sleep Quality during the COVID-19 Pandemic Predicts Higher Dietary Risk.

Health behaviors of higher education students can be negatively influenced by stressful events. The global COVID-19 pandemic presents a unique opportunity to characterize and compare health behaviors across multiple countries and to examine how these behaviors are shaped by the pandemic experience. Undergraduate and graduate students enrolled in universities in China, Ireland, Malaysia, South Korea, Taiwan, the Netherlands and the United States (USA) were recruited into this cross-sectional study. Eligible students filled out an online survey comprised of validated tools for assessing sleep quality and duration, dietary risk, alcohol misuse and physical activity between late April and the end of May 2020. Health behaviors were fairly consistent across countries, and all countries reported poor sleep quality. However, during the survey period, the COVID-19 pandemic influenced the health behaviors of students in European countries and the USA more negatively than Asian countries, which could be attributed to the differences in pandemic time course and caseloads. Students who experienced a decline in sleep quality during the COVID-19 pandemic had higher dietary risk scores than students who did not experience a change in sleep quality (p = 0.001). Improved sleep quality was associated with less sitting time (p = 0.010). Addressing sleep issues among higher education students is a pressing concern, especially during stressful events. These results support the importance of making education and behavior-based sleep programming available for higher education students in order to benefit students' overall health.