COVID-19 Control Research Articles

Mental health status of Chinese residents and its associated factors in the aftermath of the COVID-19 pandemic: A cross-sectional study

BackgroundDuring the COVID-19 pandemic, numerous studies focused on mental health, but few considered both positive and negative aspects within the dual-factor model of psychological well-being. In China, a highly populous country, limited evidence exists regarding mental health and its associated factors following the surge and decline of COVID-19 cases after the loosening of COVID-19 control measures. This study aims to investigate the mental health status of Chinese residents in the aftermath of the pandemic and factors influencing positive and negative indicators using the System-Based Model of Stress. MethodsA cross-sectional online survey of 1,026 participants was conducted in China from March 2–31, 2023, using quota sampling. Structural equation modeling (SEM) was performed to test the conceptual model, where social support, perceived susceptibility, perceived severity, pandemic-related events, coping style, and concern about COVID-19 were considered as predictors, and psychological distress and subjective well-being as outcomes. ResultsThe results revealed high prevalence rates of psychological distress (23 %) with either of anxiety (15 %) or depression (20 %), and poor subjective well-being (23 %) among Chinese residents after the COVID-19 pandemic. Social support was negatively correlated with psychological distress, and negative coping style, pandemic-related events, and concern about COVID-19 were positively correlated with psychological distress. Moreover, social support was positively correlated with subjective well-being, and negative coping style and pandemic-related events were negatively correlated with subjective well-being. ConclusionsThese findings enhance our understanding of the differing correlates of positive and negative mental health, suggesting targeted psychological interventions for post-pandemic and future public health events.

Analysis of preference for COVID-19 measures at hotels: a choice experiment in Japan

ABSTRACT This study examines the preference for COVID-19 measures in hotels during the pandemic. In November 2022, we conducted a choice experiment in Japan. The results of a conditional logit model demonstrate that mask wearing during conversation in restaurants was preferred, followed by the installation of air purifiers, the individual packaging and disposal of amenities, nonface-to-face check-in, and the individual packaging and disinfection of amenities. The results of a latent class model reveal preference heterogeneity, especially for mask wearing. In cases where trade-offs exist between COVID-19 control and environmental measures, COVID-19 control is preferred even among those who are environmentally conscious. There is preference heterogeneity. Understanding the need for diverse levels of infection measures is necessary to ensure that diverse individuals have access to services that suit their needs. What we learned from the COVID-19 pandemic can be applied when we face new infectious diseases in the future.

Burden of noncommunicable diseases and COVID-19 pandemic prevention and control strategies

Noncommunicable diseases (NCDs) are the leading cause of death in 21st century. The risk factors for development and progression of NCDs include sedentary lifestyle, inadequate fruits and vegetables intake, tobacco use, high blood pressure, high total cholesterol levels, obesity, high salt intake, low physical activity, and air pollution. People with NCDs and comorbidities like hypertension, cardiovascular diseases, diabetes, chronic respiratory infection and cancer are more vulnerable to severe COVID-19 infection that ultimately results into mortality. To reduce the impact of NCDs on COVID-19 cases, prevention is the best measure. Primary and secondary level prevention of NCDs plays a main role to control bad outcome in COVID-19 cases. The strategies that are required to address this comorbidity includes integration and convergence of the existing communicable and NCD programs, strengthening health care systems by giving major focus on primary health care services, health and wellness centers, universal health coverage, updating guidelines, enhancing community participation, capacity building, appropriate policy making, multi-sectoral participation and coordination.

Parental Hesitancy toward Seasonal Influenza Vaccination for Children under the Age of 18 Years and Its Determinants in the Post-Pandemic Era: A Cross-Sectional Survey among 1175 Parents in China.

Children's susceptibility to influenza increased after COVID-19 control measures were lifted. This study investigated parental hesitancy toward seasonal influenza vaccination (SIV) for children and its determinants in the post-pandemic era. An online survey of full-time adult factory workers was conducted in Shenzhen, China in December 2023. This analysis was based on 1175 parents who had at least one child under the age of 18 years. Among all parents, 37.1% were hesitant to have their index child receive SIV. Mothers exhibited lower parental hesitancy toward SIV compared to fathers (31.9% versus 41.3%, p < 0.001). After adjusting for significant background characteristics, mothers and fathers who were more satisfied with the SIV health promotion materials, perceived more severe consequences of seasonal influenza for their children, and perceived more benefits, cues to action, and self-efficacy related to their children's SIV were less likely to exhibit hesitancy toward SIV. Higher frequency of exposure to information about the increasing number of patients or severe cases due to seasonal influenza and other upper respiratory infections on social media was associated with lower parental hesitancy toward SIV among fathers but not mothers. There is a strong need to address parental hesitancy toward SIV for children in the post-pandemic era.

EFFECT OF COVID-19 ON PAIN, FALL FREQUENCY, FEAR OF FALLING, AND PHYSICAL ACTIVITY LEVEL IN OLDER PEOPLE: A CROSS-SECTIONAL STUDY

Purpose: People who have recovered from COVID-19 may experience a range of symptoms. These symptoms are linked to negative changes in pain, falls, fear of falling, and physical activity. The current study aimed to investigate the effect of COVID-19 on pain, fall frequency, fear of falling, and physical activity level in older people, as well as identify associated factors with these variables. Methods: Participants were divided into two groups for this cross-sectional study: COVID-19 (n=48) and healthy control (n=66). Pain, number of falls, fear of falling, and physical activity level of the participants were assessed. Multiple linear regression analysis was also used to identify factors associated with these variables. Participants were also asked about their demographics, illnesses, post-COVID-19 symptoms, smoking habits, who they lived with, how long they had been infected with COVID-19, hospitalization due to COVID-19, and the doses of the vaccine. Results: Pain, fatigue, and cognitive impairment were found to be significantly more prevalent in the COVID-19 group (p=0.001, p=0.021, p=0.011, respectively). When compared to the control group, the COVID-19 group showed worse results in terms of pain intensity, the number of falls, fear of falling, and physical activity level (p=0.009, p=0.030, p=0.005, p

Preventing the re-establishment of malaria during the COVID-19 pandemic in Sri Lanka: implications for health security

BackgroundThe COVID-19 pandemic—with its first reported case in Sri Lanka in March 2020—had the potential to impact the risk of re-establishing malaria, a disease which was eliminated from Sri Lanka in 2012. Post-elimination, the country remains highly vulnerable to a return of malaria on account of high vector mosquito densities and the inflow of imported malaria cases.MethodsParallels between COVID-19 and malaria after its elimination as health security threats were drawn, and the many ways in which the COVID-19 pandemic impacted the prevention of re-establishment of malaria programmes in the country in 2020 were examined. The implications of this experience for global health security are analysed.ResultsIn 2020, imported malaria cases were fewer than in the previous 3 years, due to restrictions on international travel. Yet, a high level of malaria case and entomological surveillance was sustained through surveillance strategies modified to focus on quarantine centers, in response to the pandemic. As a result, more imported malaria cases were detected by active case detection than by passive surveillance. Some of the operational shifts adopted by the Anti Malaria Campaign were moving rapidly into functioning as an intersectoral player by reinforcing its collaborations with the Ministries of Aviation and Defense, switching to the use of online communication systems, and integrating and synergizing its field activities with the COVID-19 control programme.ConclusionsThe experience highlights the need for disease control programmes to be agile, flexible and responsive, and underscores the importance of maintaining even a lean focal programme for diseases such as malaria after they have been eliminated. Sustaining public health leadership and robust technological capacities in communication and data management were paramount in preventing the disruption of the malaria prevention programme during the pandemic and sustaining the malaria-free status of the country.

Seroprevalence of B. pertussis infection and the changes of specific antibody levels in health care workers during the first two years of COVID-19 in Wuhu, China

BackgroundThe reported number of pertussis cases declined after the implementation of COVID-19 prevention and control measures, however, the burden of pertussis among adults in China remains largely unknown. Additionally, the waning of natural antibody level has also rarely been assessed. MethodsA total of 762 healthcare workers (HCWs) who had underwent the health examinations in 2021 and 2022 were included. Serum anti-PT IgG and IgA levels were determined by ELISA. Recent B. pertussis infection was defined as anti-PT IgG ≥100 IU/ml and/or anti-PT IgA ≥10 IU/ml. ResultsIn 2021, the seroprevalence of recent B. pertussis infection was 10.1 %, and those HCWs in outpatient department had a higher percentage (18.6 %), and geometric mean concentration (GMC) (6.3 IU/ml) than those in other departments. This seroprevalence decreased to 2.4 % in 2022, although the difference remained significant. In the 77 subjects with recent B. pertussis infection in 2021, anti-PT IgG was undetectable in 18 cases the following year. Majority (68/76) of the subjects with anti-PT IgA ≥10 IU/ml in 2021 no longer had detected this antibody in 2022. Among 95 pertussis cases, approximately 60.0 % of cases reported no history of cough. Among those with a documented cough history, 36 cases with suspected pertussis courses who had never been diagnosed. Prolonged cough with nocturnal exacerbation (29/38) was the most commonly reported clinical symptom, and whoop was confirmed in six cases. Uroclepsia and syncopes during the cough attacks were reported by three and one subjects, respectively. One case presented with subconjunctival hemorrhage and tensionic purpura during the course. ConclusionsThe results suggested a high prevalence of B. pertussis infection among HCWs. The presence of unrecognized adult pertussis cases and the rapid waning of antibody indicate the need to improve clinical management for suspected pertussis in adults, and to updated immunization schedule after childhood program.

The assembly of neutrophil inflammasomes during COVID-19 is mediated by type I interferons.

The severity of COVID-19 is linked to excessive inflammation. Neutrophils represent a critical arm of the innate immune response and are major mediators of inflammation, but their role in COVID-19 pathophysiology remains poorly understood. We conducted transcriptomic profiling of neutrophils obtained from patients with mild and severe COVID-19, as well as from SARS-CoV-2 infected mice, in comparison to non-infected healthy controls. In addition, we investigated the inflammasome formation potential in neutrophils from patients and mice upon SARS-CoV-2 infection. Transcriptomic analysis of polymorphonuclear cells (PMNs), consisting mainly of mature neutrophils, revealed a striking type I interferon (IFN-I) gene signature in severe COVID-19 patients, contrasting with mild COVID-19 and healthy controls. Notably, low-density granulocytes (LDGs) from severe COVID-19 patients exhibited an immature neutrophil phenotype and lacked this IFN-I signature. Moreover, PMNs from severe COVID-19 patients showed heightened nigericin-induced caspase1 activation, but reduced responsiveness to exogenous inflammasome priming. Furthermore, IFN-I emerged as a priming stimulus for neutrophil inflammasomes. These findings suggest a potential role for neutrophil inflammasomes in driving inflammation during severe COVID-19. Altogether, these findings open promising avenues for targeted therapeutic interventions to mitigate the pathological processes associated with the disease.

Evaluation of circulating microvesicles and their procoagulant activity in patients with COVID-19

ObjectiveSeveral pathological conditions trigger the formation of microvesicles (MVs), including infectious diseases such as COVID-19. The shedding of MVs increases the levels of inflammatory factors (e.g., interleukin-6; IL-6) and ultimately leads to an inflammatory cascade response, while also increasing the procoagulant response. The current study aimed to evaluate the level of circulating MVs and their procoagulant activity as well as the serum level of IL-6 in patients with COVID-19 and healthy controls. In this case-control study, 65 patients with COVID-19 and 30 healthy individuals were sampled after obtaining written informed consent. MVs counting was measured using conjugated CD61, CD45, CD235a, and Annexin-V antibodies. Additionally, the procoagulant activity of MVs and the IL-6 level were estimated using enzyme-linked immunosorbent assay (ELISA).ResultsThe majority of MVs were platelet-derived MVs (PMVs). Patients with COVID-19 had significantly higher levels of MVs, procoagulant MVs, and IL-6 compared to healthy controls (p < 0.001). MVs were significantly correlated with procoagulant MVs, D-Dimer levels, fibrinogen, and IL-6, but not with platelet, lymphocyte, and neutrophil counts.ConclusionElevated levels of procoagulant MVs and their association with inflammatory and coagulation markers in patients with COVID-19 are suggested as a novel circulatory biomarker to evaluate and predict the procoagulant activity and severity of COVID-19.

COVID-19 infection prevention and control program for aged care providers: a quasi-experimental study of Telegram-based training

ABSTRACT Given the high turnover of care workers in residential aged care facilities, continuous training on infection prevention and control (IPC) remains essential even after the COVID-19 pandemic. This study examined the impact of a Telegram-based training on aged care providers’ IPC knowledge, attitudes, self-efficacy. A two-arm, pre-post quasi-experimental study with repeated measures at week 2 (T1) and week 4 (T2) was conducted for seventy-two (72) participants from 14 residential aged care facilities in Malaysia, with 60 completing the study (30 per arm). All instructional activities and data collection for both groups were delivered through Telegram. The intervention group received a 2-day synchronous workshop (3 h/day) alongside e-materials for a 10-unit IPC module. Primary outcomes were measured using a knowledge test, COVID-19 Elderly Caregiver Questionnaire (attitude component), and an adapted General Self-Efficacy Scale. Telegram’s acceptability was also assessed using an adapted Technology Acceptance Model questionnaire. Results showed that the intervention group had a faster knowledge transfer (91.3%–93.5%; T0-T2 = ∆22.9; p ≤ .002;), higher knowledge scores (∆7.2–16; p ≤ .002; large effect sizes 0.9–1.7), and a small-to-modest increments in self-efficacy (∆13.2; p = .002) and attitude (∆5.2; p = .045). Integrating synchronous sessions into an online program improved knowledge transfer, enhanced self-efficacy and promoted positive attitudes by enabling real-time interpersonal communication and instant feedback. Telegram proved effective for mobile learning in aged care settings with limited resources.

Deep Learning-Based Prediction of Daily COVID-19 Cases Using X (Twitter) Data.

Due to the importance of COVID-19 control, innovative methods for predicting cases using social network data are increasingly under attention. This study aims to predict confirmed COVID-19 cases using X (Twitter) social network data (tweets) and deep learning methods. We prepare data extracted from tweets by natural language processing (NLP) and consider the daily G-value (growth rate) as the target variable of COVID-19, collected from the worldometer. We develop and evaluate a time series mixer (TSMixer) predictive model for multivariate time series. The mean squared error (MSE) loss on the test dataset was 0.0063 for 24-month Gvalue prediction when using the MinMax normalization with recursive feature elimination (RFE) and average or min aggregation method. Our findings illuminate the potential of integrating social media data to enhance daily COVID-19 case predictions and are applicable also for epidemiological forecasting purposes.

Using a Syndemics Perspective to (Re)Conceptualize Vulnerability during the COVID-19 Pandemic: A Scoping Review.

Syndemics theory has been applied to study interactions between biomedical and social factors leading to the clustering of diseases. Because syndemics theory focuses on interactions that enhance risk, the concept of vulnerability is central to this approach. We conducted a scoping review to better understand how this theoretical framework helped to define, operationalize, and tackle issues of vulnerability during the COVID-19 pandemic. Original research, reviews, and opinion pieces elaborating on syndemics, vulnerability, and COVID-19, published between December 2019 and October 2022 and available from PubMed, were eligible. We analyzed 40 records and identified three framings of syndemics operating during this period: (1) interactions between COVID-19, diseases/health conditions, and specific social factors; (2) interactions between COVID-19 and social determinants of health; and (3) impacts of COVID-19 on specific populations. Emerging conceptualizations described vulnerability to COVID-19 as a systemic issue, explained the impact of COVID-19 control measures on increased vulnerability, and presented COVID-19 as a syndemic on its own. However, this theory's potential for deepening our understanding of vulnerability during this pandemic was constrained by superficial explorations of the interactions between biomedical and social spheres, and insufficient theoretical and methodological support from the social sciences.

Investigating the Potential Impact of CCR5-Δ32 Variant on COVID-19 Outcome: A Case-Control Study in Iranian Population.

The impact of CCR5-Δ32 on COVID-19 outcomes has been the focus of much research. This genetic variant may protect against SARS-CoV-2 infection, while others have produced conflicting results. Given the controversial results of previous research on different populations, we aimed to investigate the possible association between the CCR5-Δ32 variant and COVID-19 severity in an Iranian population. This case-control study was conducted between 25th of April till 10th of October 2021 at Rasoul Akram Hospital of Iran University of Medical Sciences, Tehran, Iran. We investigated the association between CCR5-Δ32 genotype and COVID-19 severity in 200 unrelated Iranian patients. The patients were divided into 2 groups: 100 patients with severe COVID-19 (case group) and 100 patients with mild COVID-19 (control group). Genotyping of CCR5-Δ32 was performed using the polymerase chain reaction (PCR) technique. The frequency of CCR5-Δ32 allele was 11 in the case group and 16 in the control group. However, no significant association was found between this genetic variant and the clinical outcomes of COVID-19. The CCR5-Δ32 variant cannot serve as a reliable predictive factor for identifying individuals prone to developing severe COVID-19 in Iranian population. Additionally, targeting CCR5 would not be a viable treatment approach for COVID-19 in Iranians.

Inter-relationships among individual views of COVID-19 control measures across multi-cultural contexts

Individual-level georeferenced data have been widely used in COVID-19 control measures around the world. Recent research observed that there is a trade-off relationship between people's privacy concerns and their acceptance of these control measures. However, whether this trade-off relationship exists across different cultural contexts is still unaddressed. Using data we collected via an international survey (n = 4260) and network analysis, our study found a substantial trade-off inter-relationship among people's privacy concerns, perceived social benefits, and acceptance across different control measures and study areas. People's privacy concerns in culturally tight societies (e.g., Japan) have the smallest negative impacts on their acceptance of pandemic control measures. The results also identify people's key views of specific control measures that can influence their views of other control measures. The impacts of these key views are heightened among participants with a conservative political view, high levels of perceived social tightness, and vertical individualism. Our results indicate that cultural factors are a key mechanism that mediate people's privacy concerns and their acceptance of pandemic control measures. These close inter-relationships lead to a double-edged sword effect: the increased positive impacts of people's acceptance and perceived social benefits also lead to increased negative impacts of privacy concerns in different combinations of control strategies. The findings highlight the importance of cultural factors as key determinants that affect people's acceptance or rejection of specific pandemic control measures.

Modelling on COVID-19 control with double and booster-dose vaccination

COVID-19 vaccines have been illustrated to lessen the growth of sickness caused by the virus effectively. In any case, inoculation has consistently been controversial, with differing opinions and viewpoints. This has compelled some individuals to decide against receiving the vaccine. These divergent viewpoints have had a trivial impact on the epidemic’s dynamics and the disease’s development. In response to vaccinated individuals still falling ill, many countries have implemented booster vaccines to protect further.In this specific investigation, a mathematical model composed of seven compartments is employed to examine the effectiveness of a booster dose in preventing and treating the transmission of COVID-19. The principles of mathematics are employed to analyse and investigate the dynamics of the disease. Using a qualitative prototype analysis, we acquired valuable insights into its effectiveness. One essential aspect is the basic reproduction number, a critical determinant of the disease’s spread. This calculation is determined by studying the system’s equilibrium and evaluating its stability.Furthermore, we examined the balance from a local and global viewpoint, considering the possibility of bifurcation and the model’s reproductive number sensitivity index. Through numerical simulations, we have visually illustrated the analytical findings outlined in this research paper and presented a thorough examination of the efficacy of booster shots as a preventive and therapeutic measure in the spread dynamics of COVID-19.

Toward better pandemic governance and preparedness: South Korea’s whole-of-nation approach to COVID-19

BackgroundThe profound impact of coronavirus disease (COVID-19) has led to an increased demand for sustainable pandemic governance practices. This study explored emerging hybrid governance practices that provide robust evidence on how to address the complex challenges of pandemics effectively. South Korea, which was severely affected by COVID-19, has implemented a novel governance approach using a whole-of-nation (WoN) model. This hybrid pandemic governance approach, which integrates both whole-of-government and whole-of-society approaches, has enabled synergistic and cohesive multi-sectoral coordination among all stakeholders (public authorities, private enterprises, and civil society) to address multifaceted challenges collectively and strengthen their resilience capacity. This study investigated South Korea’s WoN practices and their embedded context and identified key governance enablers facilitating this approach.MethodsThis study employed a case study design based on an extensive analysis of policy and program documents, drawing on South Korea’s publicly available data from January 1, 2020 to March 30, 2023. It assessed six system-level collaborative pandemic governance practices and key enablers, all of which were intended to fortify the country’s pandemic response.ResultsThe primary areas of the country’s WoN governance practices for COVID-19 control were (i) whole-of-government policy-making and response, (ii) COVID-19 testing system, (iii) digital surveillance of COVID-19, (iv) COVID-19 triage and treatment system, (v) domestic vaccine production, and (vi) community engagement. Key governance enablers for implementing the WoN model were establishing a legal foundation, ensuring decisive and strong governance and leadership, increasing public investment, applying a whole-of-health approach with augmented investment in public health, enhancing crisis communication, and mobilizing local leaders and civil society organizations in the national public health response.ConclusionsIn exploring innovative approaches to pandemic governance for increased efficacy, responsiveness, and impact, the WoN approach emerged as highly relevant. This example of emerging practice allows policy-makers to re-evaluate their governance strategies and initiatives to improve multi-agency partnerships across the country in their pandemic-preparedness planning.

Clinical characteristics and outcomes of patients with candidemia during the COVID-19 pandemic: Insights from experience in the Omicron era

BackgroundIn Taiwan, COVID-19 outbreaks caused by the Omicron variant occurred in 2022. We investigated the incidence of candidemia during COVID-19 pandemic and the mortality of candidemia patients with COVID-19 in Taiwan. MethodsThe incidence of candidemia and fluconazole susceptibility of Candida species before (2015–2019) and during COVID-19 pandemic (2020–2023) at Kaohsiung Chang Gung Memorial Hospital were investigated. The associated factors with mortality in candidemia patients during COVID-19 pandemic were analyzed. Candidemia patients who had COVID-19 within the prior 90 days (case group, n = 34) were propensity-score matched for age, ICU admission, and abdominal surgery in a 1:4 ratio with candidemia patients without COVID-19 (control group, n = 136). ResultsAge (adjusted odds ratio [AOR] = 1.02, 95% CI: 1.01–1.03), ICU stay (AOR = 1.84, 95% CI: 1.29–2.62), higher Charlson comorbidity index (AOR = 1.08, 95% CI: 1.03–1.13), corticosteroid use (AOR = 1.50, 95% CI: 1.04–2.17) were associated with increased risk of mortality; abdominal surgery (AOR = 0.47, 95% CI: 0.29–0.74) and infected by Candida parapsilosis (AOR = 0.61, 95% CI: 0.38–0.98) were associated with decreased risk of mortality. After matching, there was no significant difference in mortality rates between the case and control groups. The incidence of candidemia increased from 196 to 278 patients/100,000 admissions during COVID-19 pandemic, while the causative species of candidemia and fluconazole susceptibility rates were similar. ConclusionWhile the incidence of candidemia increased during COVID-19 pandemic, there was no significant difference in mortality between candidemia patients with and without COVID-19 in the Omicron era.

A Mixed Methods Exploration of Young Women's Agency and Mental Health during COVID-19 in Low-Income Communities in Mumbai, India.

Adolescent girls and young women (AGYW) in India face additional health inequities compared to their male peers, as gender norms constrain agency for prevention and self-care. The onset of the COVID-19 pandemic and associated lockdowns deepened health inequities and often worsened mental health, but the impacts on agency are unclear. This exploratory sequential mixed methods paper examined mental health and COVID-19 elements that exacerbated or mitigated adverse consequences for AGYW in low-income communities in Mumbai. We conducted semi-structured interviews with AGYW (aged 15-25 years; N = 60) and adults (parents, healthcare providers, community-based organization representative; N = 30). We administered a structured survey to AGYW (N = 150) to assess health concerns, depression and anxiety symptoms (using the PHQ-8 and GAD-7 scales), and experiences during COVID-19. We analyzed qualitative data using the constant comparative approach in Atlas.ti, and quantitative data using R and SPSS. Qualitative data revealed that AGYW faced stressors and had limited agency during lockdowns due to limited access to education, financial insecurity, and community violence. Quantitative data indicated that limited agency in the context of COVID-19 was significantly associated with depression and anxiety. Financial resources to address COVID-19 created new employment and leadership opportunities for AGYW to become COVID educators and preschool teachers; participation in these opportunities was associated with less anxiety. Pandemic stress was difficult for low-income AGYW in Mumbai. Mitigating programs for COVID-19 control helped address acute needs and enable capabilities. Exploring similar themes among a broader population of youth can help design strategies and opportunities for young people in low-income communities during health emergencies.

Epidemiological study of post-pandemic pediatric common respiratory pathogens using multiplex detection

BackgroundThe burden and characteristics of respiratory viral infections in children hospitalized for acute respiratory tract infections (ARTIs) during the post-COVID-19 pandemic era are unclear. We analyzed the epidemiological and clinical characteristics of pediatric patients hospitalized with common respiratory virus infections before and after relaxation of non-pharmaceutical interventions in Hangzhou, China and evaluated the diagnostic value of the six-panel respiratory pathogen detection system.MethodsSix types of respiratory viruses were detected in respiratory samples from children with suspected ARTIs by multiplex real-time quantitative polymerase chain reaction (RT-qPCR). Changes in virus detection rates and epidemiological and clinical characteristics, obtained from electronic health records, were analyzed. Binary logistic regression was used to identify respiratory tract infections risk factors. Multiplex RT-qPCR and targeted next-generation sequencing results were compared in random samples.ResultsAmong the 11,056 pediatric samples, 3228 tested positive for one or more of six common respiratory pathogens. RSV and PIV-3 detection rates differed significantly across age groups (both P < 0.001), and were more common in younger children. PIV-1 was more common in infants, toddlers, and preschoolers than in school-age children (P < 0.001). FluB was predominantly detected in school-age children (P < 0.001). RSV-, ADV-, and PIV-1-positivity rates were higher in 2022 than in 2023. Seasonal viral patterns differed across years. RSV (OR 9.156. 95% CI 5.905–14.195) and PIV-3 (OR 1.683, 95% CI 1.133–2.501) were risk factors for lower respiratory tract infections. RSV-positivity was associated with severe pneumonia (P = 0.044). PIV-3 (OR 0.391, 95% CI 0.170–0.899), summer season (OR 1.982, 95% CI 1.117–3.519), and younger age (OR 0.938, 95% CI 0.893–0.986) influenced pneumonia severity. Multiplex RT-qPCR showed good diagnostic performance.ConclusionAfter changes in COVID-19 prevention and control strategies, six common respiratory viruses in children were prevalent in 2022–2023, with different seasonal epidemic characteristics and age proclivities. RSV and PIV-3 cause lower, and FluA, FluB, and ADV more typically cause upper respiratory tract infections. Infancy and summer season influence severe pneumonia risk. Multiplex RT-qPCR is valuable for accurate and timely detection of respiratory viruses in children, which facilitates management, treatment, and prevention of ARTIs.

MRI evidence of gray matter loss in COVID-19 patients with cognitive and olfactory disorders.

The aim of this study was to assess COVID-19-related gray matter (GM) structural alterations in two distinct groups of patients presenting with the prevailing and distinctive COVID-19-related neurological symptoms - isolated olfactory disorders as sole neurological manifestation (COVID-OD) and cognitive disorders (COVID-CD) - as compared to a control group of unaffected individuals. The study included 61 COVID-CD patients (57 [60-63] years, 62% females), 84 COVID-OD patients (49 [35-57] years, 60% females), and 17 controls (51 [41-52] years, 41% females). Region-based morphometry (RBM) and voxel-based morphometry (VBM) were performed on T1-weighted MRI scans to assess GM regional volume and voxel-wise density differences between COVID-19 patients and controls. Surface-based morphometry (SBM) was applied to investigate cortical thickness alterations. The statistical models built to assess GM structural differences among groups included total intracranial volume and age as nuisance variables. The multi-morphometric analysis revealed statistically significant (p < 0.05 corrected for multiple comparisons) reduction in GM regional volumes, in voxel-wise GM density and in cortical thickness in both COVID-CD and COVID-OD patient groups as compared to controls. Across all three analyses, COVID-CD patients showed more distributed and severe GM loss than COVID-OD patients. The most prominently affected GM regions in the COVID-CD group included the hippocampus, putamen, cingulate gyrus, precuneus, precentral and postcentral gyri, amygdala, lingual gyrus, and caudate nucleus. Our MRI findings show that COVID-19-related olfactory and cognitive disorders both induce GM atrophy, although at different degrees of severity, likely indicative of neurodegeneration and neuroinflammation.