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Background: Agitation is a disabling neuropsychiatric symptom of dementia. Pro re nata (PRN) injections of psychotropics can be administered for severe acute agitation, but little is known about the frequency of their actual use. Objective: Characterize actual use of injectable PRN psychotropics for severe acute agitation in Canadian long-term care (LTC) residents with dementia and compare use before and during the COVID-19 pandemic. Methods: Residents from two Canadian LTC facilities with orders for PRN haloperidol, olanzapine, or lorazepam between January 1, 2018- May 1, 2019 (i.e., pre-COVID-19) and January 1, 2020- May 1, 2021 (i.e., COVID-19) were identified. Electronic medical records were reviewed to document PRN injections of psychotropic medications and collect data on reason and demographic characteristics. Descriptive statistics were used to characterize frequency, dose, and indications of use, and multivariate regression models were used to compare use between time periods. Results: Of the 250 residents, 45 of 103 (44%) people in the pre-COVID-19 period and 85 of 147 (58%) people in the COVID-19 period with standing orders for PRN psychotropics received ≥1 injections. Haloperidol was the most frequently used agent in both time periods (74% (155/209 injections) pre-COVID-19; 81% (323/398 injections) during COVID-19). Residents in the COVID-19 period were almost two times more likely to receive injections compared with those in the pre-COVID-19 period (odds ratioâ=â1.96; 95% CIâ=â1.15-3.34; pâ=â0.01). Conclusion: Our results suggest that use of PRN injections increased in LTC during the pandemic and contribute to the mounting evidence that agitation worsened during that time.
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BACKGROUND: The Delta variant of SARS-COV-2 has replaced previously circulating strains around the world in 2021. Sporadic outbreaks of the Delta variant in China have posed a concern about how to properly respond to the battle against evolving COVID-19. Here, we analyzed the "hierarchical and classified prevention and control (HCPC)" measures strategy deployed during the recent Guangzhou outbreak. METHODS: A modified susceptible-exposed-pre-symptomatic-infectious-recovered (SEPIR) model was developed and applied to study a range of different scenarios to evaluate the effectiveness of policy deployment. We simulated severe different scenarios to understand policy implementation and timing of implementation. Two outcomes were measured: magnitude of transmission and duration of transmission. The outcomes of scenario evaluations were presented relative to the reality case (i.e., 368 cases in 34 days) with 95% confidence interval (CI). RESULTS: Based on our simulation, the outbreak would become out of control with 7 million estimated infections under the assumption of the absence of any interventions than the 153 reported cases in reality in Guangzhou. The simulation on delayed implementation of interventions showed that the total case numbers would also increase by 166.67%-813.07% if the interventions were delayed by 3 days or 7 days. CONCLUSIONS: It may be concluded that timely and more precise interventions including mass testing and graded community management are effective measures for Delta variant containment in China.
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COVID-19 , SARS-CoV-2 , Humains , COVID-19/épidémiologie , COVID-19/prévention et contrôle , Épidémies de maladies , Chine/épidémiologieRésumé
SARS-CoV-2 Omicron subvariants have become the predominantly strain in most countries. However, the neutralizing activity of the human serum after Omicron-based vaccine booster against different SARS-CoV-2 variants is poorly understood. Here, we developed an update Omicron vaccine (SCoK-Omicron), based on the RBD-Fc fusion protein vaccine (SCoK) and RBD domain of Omicron BA.1. To assess cross-variant neutralizing activity in adults, 25 volunteers that have received three doses of SCoK and 25 volunteers with two doses of CoronaVac (inactive vaccine) were further boosted with a dose updated vaccine (SCoK-Omicron). The results of pseudovirus neutralization assays demonstrated that the booster potently induced the high-level of neutralizing antibody against SARS-CoV-2 Wild type, Delta and Omicron subvariants in adults. Further assays of single point mutations showed that K444T, L452R, N460K, or F486V was key mutations to cause immune evasion. Together, these data suggest that SCOK-Omicron can be used as a booster vaccine candidate in adults receiving subunit protein or inactivated vaccine in response to the epidemic of COVID-19 Omicron subvariants, and the mutation K444T, L452R, N460K, or F486V needs to be considered in future vaccine design.
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COVID-19 , Vaccins , Humains , Adulte , SARS-CoV-2/génétique , COVID-19/prévention et contrôle , Anticorps neutralisants , Anticorps antivirauxRésumé
In the original publication [...].
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The association between the COVID‐19 pandemic and the wildlife trade in the seafood market in Wuhan has raised public concern regarding wildlife consumption and public health safety. Considering several coronavirus transmission incidents related to aquatic products and the location of wild freshwater fish in aquatic consumption in China, the effects of COVID‐19 on the purchase intention of wild freshwater fish was investigated. Based on 1163 online questionnaires from eight provinces (including two province‐level municipalities) in the Yangtze River Basin, ordered logistic regression was carried out to analyze the influencing factors of purchase intention of wild freshwater fish during the COVID‐19 pandemic. The empirical results indicated that the COVID‐19 pandemic had changed consumers' perceived risk and purchase frequency of wild freshwater fish. External stimulus caused by the COVID‐19 pandemic had little influence on perceived risk and purchase intention. Consumer preference had a significant impact on perceived risk and purchase intention. Therefore, efforts should be put to strengthen the popularization of aquatic product knowledge, guide the public to develop scientific and civic eating habits, and improve the traceability system of aquatic products. [EconLit Citations: D12‐Consumer Economics: Empirical Analysis, Q22‐Fishery;Aquaculture].
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There is evidence that it may be possible to detect viruses and viral infection optically using techniques such as Raman and infrared (IR) spectroscopy and hence open the possibility of rapid identification of infected patients. However, high-resolution Raman and IR spectroscopy instruments are laboratory-based and require skilled operators. The use of low-cost portable or field-deployable instruments employing similar optical approaches would be highly advantageous. In this work, we use chemometrics applied to low-resolution near-IR (NIR) reflectance/absorbance spectra to investigate the potential for simple low-cost virus detection suitable for widespread societal deployment. We present the combination of near-IR spectroscopy (NIRS) and chemometrics to distinguish two respiratory viruses, respiratory syncytial virus (RSV), the principal cause of severe lower respiratory tract infections in infants worldwide, and Sendai virus (SeV), a prototypic paramyxovirus. Using a low-cost and portable spectrometer, three sets of RSV and SeV spectra, dispersed in phosphate-buffered saline (PBS) medium or Dulbecco's modified eagle medium (DMEM), were collected in long- and short-term experiments. The spectra were preprocessed and analyzed by partial least-squares discriminant analysis (PLS-DA) for virus type and concentration classification. Moreover, the virus type/concentration separability was visualized in a low-dimensional space through data projection. The highest virus-type classification accuracy obtained in PBS and DMEM is 85.8% and 99.7%, respectively. The results demonstrate the feasibility of using portable NIR spectroscopy as a valuable tool for rapid, on- site, and low-cost virus prescreening for RSV and SeV with the further possibility of extending this to other respiratory viruses such as SARS-CoV-2.
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Vaccination is a cost-effective medical intervention. Inactivated whole virusor large protein fragments-based severe acute respiratory syndrome coronavirus (SARS-CoV-2) vaccines have high unnecessary antigenic load to induce allergenicity and/orreactogenicity, which can be avoided by peptide vaccines of short peptide fragments that may induce highly targeted immune response. However, epitope identification and peptide delivery remain the major obstacles in developing peptide vaccines. Here, a multi-source data integrated linear B-cell epitope screening strategy is presented and a linear B-cell epitope enriched hotspot region is identified in Spike protein, from which a monomeric peptide vaccine (Epitope25) is developed and applied to subcutaneously immunize wildtype BALB/c mice. Indirect ELISA assay reveals specific and dose-dependent binding between Epitope25 and serum IgG antibodies from immunized mice. The neutralizing activity of sera from vaccinated mice is validated by pseudo and live SARS-CoV-2 wild-type strain neutralization assays. Then a dissolvable microneedle array (DMNA) is developed to pain-freely deliver Epitope25. Compared with intramuscular injection, DMNA and subcutaneous injection elicit neutralizing activities against SARS-CoV-2 wild-type strain as demonstrated by live SARS-CoV-2 virus neutralization assay. No obvious damages are found in major organs of immunized mice. This study may lay the foundation for developing linear B-cell epitope-based vaccines against SARS-CoV-2.
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This study compared disease progression of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) in three different models of golden hamsters: aged (≈60 weeks old) wild-type (WT), young (6 weeks old) WT, and adult (14-22 weeks old) hamsters expressing the human-angiotensin-converting enzyme 2 (hACE2) receptor. After intranasal (IN) exposure to the SARS-CoV-2 Washington isolate (WA01/2020), 2-deoxy-2-[fluorine-18]fluoro-D-glucose positron emission tomography with computed tomography (18F-FDG PET/CT) was used to monitor disease progression in near real time and animals were euthanized at pre-determined time points to directly compare imaging findings with other disease parameters associated with coronavirus disease 2019 (COVID-19). Consistent with histopathology, 18F-FDG-PET/CT demonstrated that aged WT hamsters exposed to 105 plaque forming units (PFU) developed more severe and protracted pneumonia than young WT hamsters exposed to the same (or lower) dose or hACE2 hamsters exposed to a uniformly lethal dose of virus. Specifically, aged WT hamsters presented with a severe interstitial pneumonia through 8 d post-exposure (PE), while pulmonary regeneration was observed in young WT hamsters at that time. hACE2 hamsters exposed to 100 or 10 PFU virus presented with a minimal to mild hemorrhagic pneumonia but succumbed to SARS-CoV-2-related meningoencephalitis by 6 d PE, suggesting that this model might allow assessment of SARS-CoV-2 infection on the central nervous system (CNS). Our group is the first to use (18F-FDG) PET/CT to differentiate respiratory disease severity ranging from mild to severe in three COVID-19 hamster models. The non-invasive, serial measure of disease progression provided by PET/CT makes it a valuable tool for animal model characterization.
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COVID-19 , Pneumopathie infectieuse , Humains , Animaux , Cricetinae , COVID-19/imagerie diagnostique , SARS-CoV-2 , Fluorodésoxyglucose F18 , Tomographie par émission de positons couplée à la tomodensitométrie/méthodes , Angiotensin-converting enzyme 2 , Tomographie par émission de positons , Mesocricetus , Évolution de la maladieRésumé
Objective: Given the immense stress faced by medical staff during the COVID-19 pandemic, this study aimed to evaluate the relationship between mindful attention awareness, fatigue, and perceived symptoms among frontline nurses who performed nucleic acid sample collection during the COVID-19 pandemic, to reduce their fatigue and help them cope with perceived uncomfortable symptoms. Methods: A convenience sampling method was used to survey nurses who travelled to Hainan for nucleic acid sampling in August 2022 using an online (WeChat) questionnaire. A total of 514 frontline nurses who performed nucleic acid tests completed the questionnaire. The questionnaire covered basic demographic information, Mindful Attention Awareness Scale (MAAS) ratings, and Fatigue Severity Scale (FSS) ratings. Spearman correlation analysis was used to separate the relationship between MASS and FSS, and univariate and multivariate factor analyses were used to explore the relevant influences contributing to the occurrence of fatigue. Results: A total of 514 individuals completed the survey,93.97% (n=483) were female, mean age was 31.15 ± 5.7, MASS score was 69.01 ± 13.53, and 296 (57.59%) nurses experienced symptoms of fatigue during the auxiliary period. Spearman correlation analysis showed that FSS was associated with MASS. Multifactorial analysis showed that sex, age, marital status, fertility status, years of work, adaptation to dietary habits, hidrorrhea, and MAAS scores affected the presence of fatigue symptoms among the medical staff in Hainan (P<0.05). Conclusion: The psychological status of frontline nurses undergoing nucleic acid testing during the pandemic was poor, and the appearance of fatigue symptoms could be effectively reduced by increasing levels of positive thinking among medical staff to help them cope with public health emergencies.
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Quinoline (QN) derivatives are often used for the prophylaxis and treatment of malaria. Chloroquine (CQ), a protonated, weakly basic drug, exerts its antimalarial effect mainly by increasing pH and accumulating in the food vacuole of the parasites. Repurposing CQ is an emerging strategy for new indications. Given the inhibition of autophagy and its immunomodulatory action, CQ shows positive efficacy against cancer and viral diseases, including Coronavirus 2019 (COVID-19). Here, we review the underlying mechanisms behind the antimalarial, anticancer and antiviral effects of CQ. We also discuss the clinical evidence for the use of CQ and hydroxychloroquine (HCQ) against COVID-19.
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Atmospheric pollutants, including particulate matters, nanoparticles, bioaerosols, and some chemicals, have posed serious threats to the environment and the human's health. The lungs are the responsible organs for providing the interface betweenthecirculatory system and the external environment, where pollutant particles can deposit or penetrate into bloodstream circulation. Conventional studies to decipher the mechanismunderlying air pollution and human health are quite limited, due to the lack of reliable models that can reproduce in vivo features of lung tissues after pollutants exposure. In the past decade, advanced near-to-native lung chips, combining cell biology with bioengineered technology, present a new strategy for atmospheric pollutants assessment and narrow the gap between 2D cell culture and in vivo animal models. In this review, the key features of artificial lung chips and the cutting-edge technologies of the lung chip manufacture are introduced. The recent progresses of lung chip technologies for atmospheric pollutants exposure assessment are summarized and highlighted. We further discuss the current challenges and the future opportunities of the development of advanced lung chips and their potential utilities in atmospheric pollutants associated toxicity testing and drug screening.
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Polluants environnementaux , Microfluidique , Animaux , Humains , Poumon , Techniques de culture cellulaire , Matière particulaire/toxicitéRésumé
Purpose: Based on the affective event theory and the theoretical framework of "work environment features-work events-emotional responses-work attitude", this study aims to explore how and when home-based telework negatively affects work engagement by focusing on the dual chain mediating paths of "workplace isolation-negative emotion" and "telepressure-negative emotion", and the moderating role of family-supportive leadership. Methods: A questionnaire survey was used to collect 276 self-reported responses from employees with home-based telework experience in China. Findings: (a) Home-based telework indirectly and negatively affects work engagement through the mediating chain of "workplace isolation-negative emotion"; (b) Home-based telework indirectly and negatively affects work engagement through the mediating chain of "telepressure-negative emotion"; (c) Family-supportive leadership negatively moderates the chain mediating effect of "workplace isolation-negative emotion" and "telepressure-negative emotion" between home-based telework and work engagement. In other words, the higher the level of family-supportive leadership, the weaker the negative effect of home-based telework on work engagement. Originality/Value: This study sheds additional light on the relationship between home-based telework and work engagement by constructing the influence mechanism model of home-based telework on work engagement, in which "workplace isolation-negative emotion" and "telepressure-negative emotion" act as chain mediators, and family supportive leadership as moderator. This study enriches the literature on home-based telework. Practical Implications: The findings indicates that home-based work has indirectly and negatively effects on work engagement through dual chain mediating paths of "workplace isolation-negative emotion" and "telepressure-negative emotion". However, family-supportive leadership can weaken this negative influence. Therefore, organizations need to cultivate family supportive leadership.
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Inflammation is an important part of the development of various organ diseases. The inflammasome, as an innate immune receptor, plays an important role in the formation of inflammation. Among various inflammasomes, the NLRP3 inflammasome is the most well studied. The NLRP3 inflammasome is composed of skeletal protein NLRP3, apoptosis-associated speck-like protein (ASC) and pro-caspase-1. There are three types of activation pathways: (1) "classical" activation pathway; (2) "non-canonical" activation pathway; (3) "alternative" activation pathway. The activation of NLRP3 inflammasome is involved in many inflammatory diseases. A variety of factors (such as genetic factors, environmental factors, chemical factors, viral infection, etc.) have been proved to activate NLRP3 inflammasome and promote the inflammatory response of the lung, heart, liver, kidney and other organs in the body. Especially, the mechanism of NLRP3 inflammation and its related molecules in its associated diseases remains not to be summarized, namely they may promote or delay inflammatory diseases in different cells and tissues. This article reviews the structure and function of the NLRP3 inflammasome and its role in various inflammations, including inflammations caused by chemically toxic substances.
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Inflammasomes , Protéine-3 de la famille des NLR contenant un domaine pyrine , Humains , Inflammasomes/génétique , Protéine-3 de la famille des NLR contenant un domaine pyrine/métabolisme , Inflammation , Apoptose , Caspase-1/génétique , Interleukine-1 bêta/métabolismeRésumé
Background and aims: Although COVID-19 vaccination is recommended for the patients with chronic liver disease, the clinical outcomes of COVID-19 vaccinated in patients with chronic hepatitis B (CHB) has not been well characterized. The study aimed to explore the safety and specific antibody responses following COVID-19 vaccination among CHB patients. Methods: Patients with CHB were included. All patients were vaccinated with two doses of inactivated vaccine (CoronaVac) or three doses of adjuvanted protein subunit vaccine (ZF2001). The adverse events were recorded and neutralizing antibody (NAb) were determined 14 days following the whole-course vaccination. Results: A total of 200 patients with CHB were included. Specific NAb against SARS-CoV-2 were positive in 170 (84.6%) patients. The median (IQR) concentrations of NAb were 16.32 (8.44-34.10) AU/ml. Comparison of immune responses between CoronaVac and ZF2001 vaccines showed no significant differences in neither the concentrations of NAb nor the seropositive rates (84.4 vs. 85.7%). Moreover, we observed lower immunogenicity in older patients and in patients with cirrhosis or underlying comorbidities. The incidences of adverse events were 37 (18.5%) with the most common adverse event as injection side pain [25 (12.5%)], followed by fatigue [15 (7.5%)]. There were no differences in the frequencies of adverse between CoronaVac and ZF2001 (19.3% vs. 17.6%). Almost all of the adverse reactions were mild and self-resolved within a few days after vaccination. Severe adverse events were not observed. Conclusions: COVID-19 vaccines, CoronaVac and ZF2001 had a favorable safety profile and induced efficient immune response in patients with CHB.
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Background: To look at the differences and similarities in albumin and lipid metabolism in non-severe COVID-19 infection, non-severe community-acquired pneumonia, and severe community pneumonia with underlying diseases, as well as the relationship between albumin and lipid metabolism and inflammatory mediators. Methods: This retrospective analysis comprised 253 individuals with bacterial pneumonia and COVID-19 infection (1 May 2021-1 May 2022). Routine blood examination, blood lipid levels, albumin level, C-reactive protein (CRP) levels, coagulation function, cardiac enzymes, liver function, renal function, immunological function, and bacterial culture were also collected. Correlation analysis was performed using Spearman's test for lipid parameter and Inflammatory factors in the blood. Furthermore, the multiple linear regression (MLR) analysis was employed to analyze the multicollinearity in lipidomics data. The statistical analysis was performed using SPSS statistic version 19.0. Results: There were 63 (24.90%) non-severe community-acquired pneumonia patients (NSCAP), 48 (18.97%) severe community-acquired pneumonia patients (SCAP), 112 (44.27%) non-severe COVID-19 infection patients (NSCOV), and 30 (11.86%) healthy volunteers (HV). In all, 45.59% (116/253) of the patients had underlying diseases. Patients with community-acquired pneumonia had lower albumin and cholesterol levels than those with non-severe COVID-19 infection and healthy controls (t = -3.81, -2.09, P = 0.00, 0.04). Albumin, triglyceride, cholesterol, and LDL-C levels in peripheral blood were considerably lower in the SCAP group than in the NSCAP group. Albumin, cholesterol, HDL-C, LDL-C, and aop-A were all inversely connected with CRP in the SCAP with underlying illness group, but cholesterol level was favorably correlated with lymphocyte count (R = 0.36, P = 0.01). Hypoproteinemia, hypotriglyceridemia, and an elevated neutrophil-to-lymphocyte count ratio are all risk factors for severe community-acquired pneumonia. Conclusion: Hypoalbuminemia and abnormal lipid metabolism are important indicators of bacterial infection, especially severe bacterial pneumonia.
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Graphical With continuous mutations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the severe immune escape of Omicron sub-variants urges the development of next-generation broad-spectrum vaccines, especially as booster jabs after high-level vaccination coverage of inactivated vaccines in China and many other countries. Previously, we developed a coronavirus disease 2019 (COVID-19) protein subunit vaccine ZF2001® based on the tandem homo-prototype receptor-binding domain (RBD)-dimer of the SARS-CoV-2 spike protein. We upgraded the antigen into a hetero-chimeric prototype (PT)-Beta or Delta-BA.1 RBD-dimer to broaden the cross-protection efficacy and prove its efficiency with protein subunit and mRNA vaccine platforms. Herein, we further explored the hetero-chimeric RBD-dimer mRNA vaccines and evaluated their broad-spectrum activities as booster jabs following two doses of inactivated vaccine in mice. Our data demonstrated that the chimeric vaccines significantly boosted neutralizing antibody levels and specific T-cell responses against the variants, and PT-Beta was superior to Delta-BA.1 RBD as a booster in mice, shedding light on the antigen design for the next-generation COVID-19 vaccines.
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Obesity is associated with an increase in morbidity and mortality from coronavirus disease 2019 (COVID-19). The risk is related to the cytokine storm, a major contributor to multiorgan failure and a pathological character of COVID-19 patients with obesity. While the exact cause of the cytokine storm remains elusive, disorders in energy metabolism has provided insights into the mechanism. Emerging data suggest that adipose tissue in obesity contributes to the disorders in several ways. First, adipose tissue restricts the pulmonary function by generation of mechanical pressures to promote systemic hypoxia. Second, adipose tissue supplies a base for severe acute respiratory syndrome coronavirus 2 entry by overexpression of viral receptors [angiotensin-converting enzyme 2 and dipeptidyl peptidase 4]. Third, impaired antiviral responses of adipocytes and immune cells result in dysfunction of immunologic surveillance as well as the viral clearance systems. Fourth, chronic inflammation in obesity contributes to the cytokine storm by secreting more proinflammatory cytokines. Fifth, abnormal levels of adipokines increase the risk of a hyperimmune response to the virus in the lungs and other organs to enhance the cytokine storm. Mitochondrial dysfunction in adipocytes, immune cells, and other cell types (endothelial cells and platelets, etc) is a common cellular mechanism for the development of cytokine storm, which leads to the progression of mild COVID-19 to severe cases with multiorgan failure and high mortality. Correction of energy surplus through various approaches is recommended in the prevention and treatment of COVID-19 in the obese patients.
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Tissu adipeux , COVID-19 , Obésité , Tissu adipeux/métabolisme , COVID-19/complications , Syndrome de libération de cytokines , Cytokines/métabolisme , Cellules endothéliales/métabolisme , Humains , Obésité/complicationsRésumé
BACKGROUND: Increasingly frequent global disasters such as coronavirus disease 2019 pose a threat to human health and life. The World Health Organization has called on countries to formulate detailed plans to prepare for disasters. It is critical to investigate and evaluate the disaster preparedness of nurses. PURPOSE: This study was designed to investigate the disaster preparedness and psychological condition of nurses in China and analyze the significant factors influencing their disaster preparedness. METHODS: A cross-sectional survey was conducted in 2020, and 1,313 nurses were enrolled using convenience sampling. The study questionnaires were distributed and collected via a networking platform equivalent to Amazon Mechanical Turk. The disaster preparedness of the respondents was measured using the Disaster Preparedness Evaluation Tool, the Hospital Anxiety and Depression Scale was used to evaluate anxiety and depression status, and a self-designed questionnaire developed based on a review of the literature was used to explore the potential factors of influence on disaster preparedness. RESULTS: The average score for disaster preparedness among the participants was 186.34 (SD = 40.80), which corresponded with a moderate level, especially in skill (mean score = 42.01, SD = 12.39). Items with higher scores included support for the government, personal protection, and health education, whereas items with lower scores included nursing leadership in the community, capacity to cope with chemical or biological attacks, and assessment of posttraumatic stress disorder. Disaster preparedness was negatively related with mental health, including depression and anxiety. The main factors affecting disaster preparedness included educational background, nursing specialty, prior disaster training, prior disaster rescue experience, and depression level. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: The disaster preparedness of Chinese nurses must be improved. More attention should be paid to disaster preparedness in nurses, and future tailored interventions are urgently needed to promote nursing leadership in the community, the ability to cope with chemical or biological attacks, and posttraumatic stress disorder assessments. Moreover, relieving negative emotions to promote the mental health of nurses should receive greater attention.