COVID-19 Outbreak In China Research Articles

Obinutuzumab treatment for membranous nephropathy: effectiveness and safety concerns during the COVID-19 pandemic.

Obinutuzumab is a humanized and glycoengineered anti-CD20 monoclonal antibody that has been shown to induce more profound B-cell depletion than rituximab. The effectiveness and safety of obinutuzumab in the treatment of membranous nephropathy remain unclear. This was a retrospective study conducted in Huashan Hospital, Fudan University between 1 December 2021 and 30 November 2023. Patients with membranous nephropathy were included to assess the effectiveness and safety of obinutuzumab and prevalence of severe pneumonia during the outbreak of COVID-19 in China. Eighteen patients were included in the study assessing the effectiveness of obinutuzumab. After a 12-month follow-up, 14 patients (78%) achieved remission, with six (33%) achieving complete remission and eight (44%) achieving partial remission. Among the 18 obinutuzumab-treated patients contracting COVID-19 for the first time, six (33%) developed severe pneumonia, and one died. By contrast, two of the 37 patients receiving glucocorticoids combined with cyclophosphamide, and none of the 44 patients on calcineurin inhibitors or the 46 patients on rituximab developed severe pneumonia. However, compared to patients receiving rituximab or glucocorticoids plus cyclophosphamide, the obinutuzumab-treated patients had a longer duration of membranous nephropathy and immunosuppressive therapy. Therefore, cardinal matching was employed to balance these baseline characteristics. Owing to small sample size for each regimen, patients receiving all the three non-obinutuzumab immunosuppressive regimens were grouped as a control cohort. After matching for age, gender, remission status, duration of membranous nephropathy, duration of immunosuppressive therapy, and ongoing immunosuppression, the obinutuzumab-treated patients still had a significantly higher incidence of severe pneumonia compared to those on other regimens (P=.019). Obinutuzumab was an effective treatment option for patients with membranous nephropathy. On the other hand, it was associated with a higher incidence of severe pneumonia following COVID-19 infection compared to other immunosuppressive regimens.

Persuasive Effects of Crisis Communication during Public Health Emergency Outbreaks in China.

Major global public health emergencies face unprecedented challenges, such as an infodemic and scientific disputes, and governments especially need to implement fast and effective crisis communication. Firstly, this paper takes the Elaboration Likelihood Model as a framework and constructs a crisis communication persuasion effect evaluation method with emotion analysis. Secondly, this paper takes the crisis communication at the beginning of the COVID-19 outbreak in China as an example and examines the persuasive effects of the peripheral route, represented by medical experts, and the central route, represented by mainstream media. This study finds that the peripheral route of persuasive communication can quickly establish communication trust and quickly change the public's peripheral attitude, but the persuasive effect is unstable. The central route of persuasive communication demonstrates a significantly positive, stable, and anti-interference persuasive effect. Dual-subject persuasion is an important strategy for controlling an outbreak by rapidly establishing communication trust, combating an infodemic, boosting public confidence, and popularizing medical knowledge. This study evaluates the persuasive effects of crisis communication in the early stages of the COVID-19 outbreak in China, hoping to provide valuable practical references for crisis communication during the outbreak in future global public health emergencies.

Acute angle-closure glaucoma before, during, and after the outbreak of COVID-19 in China

ObjectivesAcute angle-closure glaucoma (AACG) is a major cause of irreversible and severe visual function loss. Robust rise in AACG was observed in the ophthalmic outpatient clinics concomitant with the outbreak of COVID-19 infection in China after the relaxing of “zero-COVID policy” in early December 2022. Here we compared the demographic and clinical profiles of patients with AACG before, during and after the COVID-19 outbreak. Underlying mechanisms were tentatively investigated. MethodsThis is a retrospective comparative study. Consecutive cases with newly diagnosed AACGs in a tertiary eye hospital were retrospectively collected during December 17, 2022 to January 8, 2023. Data from the same period in 2018–2019 and 2019–2020, 2020–2021 and 2021–2022, and 2023–2024 were collected as pre-pandemic, pandemic-control, and post-pandemic control, respectively. For the patients in 2022–2023 outbreak group, COVID-19 infection was confirmed by reversed transcriptase-polymerase chain reaction or antibody test for severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) from nasopharyngeal swabs. Ocular parameters, serum electrolytes and coagulative parameters were compared between COVID-19 positive and negative AACGs in observational group. SARS-CoV-2 nucleic acid in the aqueous humor was detected. ResultsA total of 106 AACG cases were diagnosed during the outbreak period in 2022–2023. In contrast, 18 (in 2018–2019) and 22 (in 2019–2020) cases were included during pre-pandemic period, and 21 (in 2023–2024) during the post-pandemic period. Only 13 and 4 newly onset AACG were included in 2020–2021 and 2021–2022 during the pandemic-control period, respectively. Younger age and higher proportion of bilateral involvement were detected in COVID-19 outbreak group than that of other groups (p = 0.034 and p = 0.080). Sixty-eight (64.2 %) patients in the outbreak group had a confirmed COVID-19 infection. Intervals between infection and AACG attack was 52 ± 85h (0-15d). Fifty-three patients (77.9 %) reported the applications of ibuprofen or other antipyretic medications and 25 (36.8 %) reported large volume water intake before AACG attack. COVID-19-positive AACG patients had higher level of D-dimer than their negative counterparts (1.13 ± 2.60 mg/L vs. 0.46 ± 0.43 mg/L, p = 0.083). No difference in IOP, serum electrolytes, and coagulative parameters other than D-dimer was observed between COVID-19 positive and negative cases. SARS-CoV-2 were negative in the aqueous humor from 14 COVID-19 positive and 8 negative patients. ConclusionCOVID-19 infection surged the onset of AACG in patients at risk. Mental stress, water intake, increased choroidal thickness due to SARS-CoV-2 induced ACE receptor activation, and hyper-coagulation, may contribute to the disease onset. Ocular involvement should not be ignored in both routine and new systemic emergent conditions.

The association of the severity of Omicron with menstrual and premenstrual syndrome among reproductive age women in China: a cross-sectional study.

This study aimed to investigate changes in menstruation and the association of the severity of Omicron with menstruation after the nationwide outbreak of COVID-19 in China. A cross-sectional study adopted an electronic questionnaire to conduct an anonymous online survey. The survey targeted women of reproductive age who had been infected with SARS-CoV-2, and were menstruating regularly in the six months prior to the infection, and experienced at least one menstrual cycle after the infection. The 737 included participants were divided into mild and severe groups based on the severity of the infection. Deviations in first menstrual cycle post-infection were reported in 46.4% of participants (mild group 40.1% vs. severe group 55.2%, P<0.05). Menstrual changes were predominantly a late menstrual period (mild group 25.3% vs. severe group 30.4%), a shorter duration of menstrual flow (mild group 10.4% vs. severe group 14.7%), and a decrease in menstrual flow volume (mild group 16% vs. severe group 21.6%). Premenstrual syndrome symptoms in a small number of women were worse compared with pre-infection, especially in the severe group. During the second menstrual period after infection, most participants reported their menstrual characteristics had returned to those of pre-infection (mild group 88% vs. severe group 80.2%, P<0.05). In this investigation, SARS-CoV-2 infection had a substantial effect on women's menstrual characteristics, and the changes were mostly transient. Women with more severe COVID-19 symptoms experienced more significant changes. The potential long-term effects of SARS-CoV-2 on female reproductive health require further observation and research.

Identifying the Impacts of Access to Different Information on Emergency Behaviors During COVID-19 Pandemic

Existing studies have verified the effect of information access on health behaviors, while less is known about the different impacts of distinct information access in a pandemic context. This study identified four information types (including disease knowledge, dynamic news, government measures, and social news) and then investigated how different information access affected preventive behaviors via perceived risk and media credibility during the COVID-19 outbreak in China. A nationally representative sampling survey on Chinese netizens was conducted ([Formula: see text]). It found that access to dynamic news, disease knowledge, and government measures positively predicted perceived severity, while only social news positively predicted perceived susceptibility. Access to disease knowledge, government measures, and social news were positively correlated with media credibility. The mediating roles of perceived risk and media credibility were proved. Besides, the statement of “cues-to-action” was also proved, which indicated that information access impacted behavioral changes more directly rather than through the mediators during COVID-19 pandemic. These findings contribute to a better understanding of how information access impacts public health behaviors in a pandemic context.

Do firms gamble for resurrection from COVID-19?

This study investigates how firms cope with downside risk induced by COVID-19. Employing an entropy-balancing-matching and difference-in-differences analysis based on the COVID-19 outbreak in China, we find a significant increase in leverage and risk-taking for firms strongly impacted by the pandemic. The effect is concentrated on moderately financially constrained and less politically connected firms. These findings suggest that firms with fewer funding sources gamble for resurrection and shift risk to debtholders when struck by COVID-19.

Retraction: Occupational Stress and Insomnia Symptoms Among Nurses During the Outbreak of COVID-19 in China: The Chain Mediating Effect of Perceived Organizational Support and Psychological Capital

Retraction: Occupational Stress and Insomnia Symptoms Among Nurses During the Outbreak of COVID-19 in China: The Chain Mediating Effect of Perceived Organizational Support and Psychological Capital

The investment behavior of China-connected mutual funds in the pandemic: Information advantage through operational link

Focusing on the origination of the COVID-19 outbreak in China, we examine the risk-taking behavior and performance of U.S. equity mutual funds indirectly exposed to China by holding U.S. firms with operational links to the country. We find that China-connected funds are associated with lower risk and higher abnormal returns at the outbreak of the pandemic. The information advantage underlying the outperformance of these funds is reflected in their trades being mimicked by that of other funds, and in the superior timing and stock picking ability of managers. These funds also maintain higher stock liquidity positions and better portfolio diversification during the pandemic. We further identify that fund managers' ethnic origin is the underlying channel for the outperformance of China-connected funds. Our results are robust across a wide range of tests.

Exploring the Role of Traditional Chopstick Culture and Interpersonal Communication in Health Campaign-Targeted Behavior

ABSTRACT Traditional chopstick culture is widely recognized as a vital factor associated with health behavior. After the outbreak of COVID-19 in China, the Gongkuai campaign aims to change long-held traditions of communal eating habits. Little is known about the effect of individuals’ perception of traditional chopstick culture and other factors on Gongkuai campaign-targeted goal. This study investigates how social-environmental and cognitive factors motivate individuals to use serving chopsticks (the Chinese Gongkuai campaign-targeted goal) and how such effects are moderated by traditional chopstick culture. Data was collected using a nationwide online survey and analyzed using structural equation modeling. The findings revealed that campaign-generated interpersonal communication positively affects individual cognitive factors. Furthermore, cognitive factors promote behavioral intentions to use serving chopsticks. While traditional chopstick culture does not directly influence an intention to use serving chopsticks, it plays a different role in the relationships between three cognitive factors and serving chopsticks use intention. Based on the results, policy implications about how to motivate individuals to use serving chopsticks are discussed.

Rethinking Two-Way Socialisation: Cultural Governance on Chinese Social Media Platforms

During the initial outbreak of COVID-19 in China, Chinese netizens engaged in protracted entanglements with the state across major platforms. They called on the Wuhan (武汉, wuhan) government to be accountable for the rapid spread of the pandemic. Interestingly, this same group of netizens had sung praises to the Chinese Communist Party's tune and lauded the extraordinary achievements of the regime before the outbreak of COVID-19, during the seventieth anniversary of the country. In fewer than six months, the national binge spiralled into poignant criticisms. Against this backdrop, this paper investigates two questions: First, why was there a marked shift in opinions towards the state? Second, what discourse did netizens adopt when expressing their discontent? We argue that the shift is indicative of two-way socialisation in the party-state's legitimacy-building process. While netizens have bought into the official narratives of a celebratory event, they hold the state to the same standard when a crisis occurs.

Prevalence and correlates of mental health problems among different occupations of medical workers during COVID-19 outbreak in China.

Health workers involved in the fight to prevent the COVID-19 outbreak were exposed to hazards. Detailed information on mental health problems in different medical occupations is crucial. To examined the prevalence of mental health issues in three medical occupations as well as the relationships between mental health problems and correlates in each occupation. This study utilizing the Questionnaire Star program was conducted among medical workers working at medical institutions in China from February 17 to 24, 2020. The Self-Reporting Questionnaire (SRQ-20), the Zung Self-rating Anxiety Scale (SAS), and the Zung Self-rating Depression Scale (SDS) were used to assess mental health problems. The prevalence of any mental health problems in the three occupations was 43.6, 34.6, and 32.9% for nurses, paramedical workers (PMWs), and doctors, respectively. Three occupations shared some correlates, such as being overworked, not having enough time to rest, support from colleagues, and previous mental health status. There were specific factors for each occupation. For doctors, age, educational level, living status, support from family, and previous physical status were related factors in mental health problems. Working in a designated hospital for treating COVID-19, having COVID-19 event exposures, and receiving support from family were associated with the mental health problems of the nurses. PMWs' mental health problems was linked to educational level and care from supervisors or heads of department. Different medical occupations have distinct impacts on mental health issues. Policy makers and mental health professionals working to prepare for potential disease outbreaks should be aware of multiple factors in different occupations.

Comparative study on the incidence of non-COVID-19 viral pneumonia before and after the COVID-19 pandemic: A retrospective analysis based on respiratory non-COVID viral nucleic acid results

BackgroundThe impact of the coronavirus disease 2019 (COVID-19) pandemic on the etiology of non-COVID-19 viral pneumonia remains to be identified. We investigated the evolution of non-COVID-19 viral pneumonia in hospitalized patients before and after the COVID-19 pandemic. MethodsThis is a single-center retrospective study. Patients who came to West China Hospital of Sichuan University diagnosed with non-COVID-19 viral pneumonia from January 1, 2016 to December 31, 2021, were included and divided into pre- and post-COVID-19 groups according to the date of the COVID-19 outbreak in China. The results of 13 viral nucleic acid tests were compared between the two groups. ResultsA total of 5937 patients (3954 in the pre-COVID-19 group and 1983 in the post-COVID-19 group) were analyzed. Compared with the pre-COVID-19 group, the proportion of patients tested for respiratory non-COVID-19 viral nucleic acid was significantly increased in the post-COVID-19 group (14.78% vs. 22.79%, P <0.05). However, the non-COVID-19 virus-positive rates decreased from 37.9% to 14.6% after the COVID-19 outbreak (P < 0.001). Notably, non-COVID-19 viral pneumonia caused by the influenza A virus H1N1 (InfAH1N1) (2009) dropped to 0% after the pandemic. The top three viruses were InfAH1N1 (2009) (13.9%), human rhinovirus (7.4%), and human adenovirus (3.4%) in the pre-COVID-19 group, and human rhinovirus (3.8%), human respiratory syncytial virus (2.0%), human parainfluenza virus (1.1%) and InfAH3N2 (1.1%) in the post-COVID-19 group. ConclusionsThe proportion of non-COVID-19 viral pneumonia decreased significantly after the COVID-19 outbreak, among which InfAH1N1 (2009) pneumonia decreased the most dramatically.

Exploring hospital resilience protective or risk factors: lessons for future disaster response efforts.

Hospital resilience is essential in responding to disasters, but current research focuses mainly on frameworks and models rather than the protection of resilience and analysis of risk factors during public health emergencies. This study aims to examine the development of resilience in Chinese frontline hospitals during the initial COVID-19 outbreak in 2020, providing insights for future disaster response efforts. We conducted interviews with 26 hospital staff members who were involved in the initial response to the COVID-19 outbreak in China. We used a semi-structured interview approach and employed purposive sampling and snowball sampling techniques. The interview outline was guided by the 'Action Framework' proposed by the World Health Organization (WHO) for responding to infectious disease emergencies. This framework includes dimensions such as command, surveillance, risk communication, medical response, and public health response. We analyzed the collected data using Colaizzi's seven-step data analysis method and the template analysis method. WHO's 'action framework' effectively highlights the factors that contribute to hospital resilience. While medical response, including the availability of materials and facilities, the use of information technology, and the capacity for infectious disease diagnosis and treatment, remains crucial, other important aspects include awareness and beliefs about infections, treatment experience, interdisciplinary collaboration, and more. Additionally, it is essential to establish an intelligent command system, foster trusting partnerships between teams, improve monitoring capabilities for infectious disease agents, enhance risk communication through information synchronization and transparency, strengthen infection control planning, and improve environmental disinfection capabilities for effective public health emergency response. These contradictions significantly impact the enhancement of hospital resilience in dealing with major infectious disease outbreaks. In responding to sudden major infectious diseases, hospitals play a vital role within the healthcare system. Enhancing hospital resilience involves more than just improving treatment capabilities. It also requires effective command coordination at the hospital level, infection control planning, and the deployment of intelligent equipment. Additionally, planning for effective communication and coordination between hospitals, communities, and the national healthcare system can further enhance hospital resilience.

Shadow education in shadow: parental education and children’s shadow education participation before and during COVID-19

Shadow education is used not only to improve students’ educational achievements but also to maintain social reproduction by advantaged families. However, little is known about the socially stratified shadow education participation during COVID-19 when the educational environment was uncertain. Using data collected before and after the COVID-19 outbreak in China, this study finds that parental education was a strong predictor of children’s shadow education participation before COVID-19, but this relationship was disrupted during COVID-19. Students of parents of all educational levels equally participated in shadow education during the COVID-19 pandemic. This class-based equity in shadow education was largely explained by the substantive increase in shadow education participation among students of less-educated parents.

Comparison of influenza- and COVID-19-associated pulmonary aspergillosis in China.

We conducted a monocentric retrospective study using the latest definitions to compare the demographic, clinical, and biological characteristics of influenza-associated pulmonary aspergillosis (IAPA) and COVID-19-associated pulmonary aspergillosis (CAPA). The study retrospectively enrolled 180 patients, including 70 influenza/IPA patients (with positive influenza A/B and Aspergillus) and 110 COVID-19/IPA patients (with positive SARS-CoV-2 and Aspergillus). Among them, 42 (60%) and 30 (27.3%) patients fulfilled the definitions of IAPA and CAPA, respectively. The CAPA patients had significantly higher in-hospital mortality (13/31, 41.9%) than IAPA patients (8/42, 19%) with a P-value of 0.033. Kaplan-Meier survival curve also showed significantly higher 30-day mortality for CAPA patients (P = 0.025). Additionally, the CAPA patients were older, though insignificantly, than IAPA patients (70 (60-80) vs. 62 (52-72), P = 0.075). A lower percentage of chronic pulmonary disease (12.9 vs. 40.5%, P = 0.01) but higher corticosteroids use 7days before and after ICU admission (22.6% vs. 0%, P = 0.002) were found in CAPA patients. Notably, there were no significant differences in the percentage of ICU admission or ICU mortality between the two groups. In addition, the time from observation to Aspergillus diagnosis was significantly longer in CAPA patients than in IAPA patients (7 (2-13) vs. 0 (0-4.5), P = 0.048). Patients infected with SARS-CoV-2 and Aspergillus during the concentrated outbreak of COVID-19 in China had generally higher in-hospital mortality but a lower percentage of chronic pulmonary disease than those infected with influenza and Aspergillus. For influenza-infected patients who require hospitalization, close attention should be paid to the risk of invasive aspergillosis upfront.

The effect of COVID-19 infection on patients with rheumatic diseases in China.

At the end of 2022, the COVID-19 outbreak erupted in China, and BA.5.2 or BF.7 subtypes of Omicron novel variations were implicated in more than 90% of the cases. We created a real-world questionnaire survey to better understand how this new variant pandemic was affecting rheumatic patients in China. During the COVID-19 outbreak in China, the subjects of this study were rheumatic patients and non-rheumatic individuals (control group), who were matched for sex and age. Professional physicians carefully questioned the participants before administering a questionnaire as part of the study. This study focused on the general baseline characteristics, clinical symptoms and treatment after COVID-19 infection, and the target populations' awareness of COVID-19. The study included 1130 participants, of whom 572 were assigned to the rheumatic group and 558 to the control group. The percentage of vaccinated controls was significantly higher than that of rheumatic patients (90.1% vs. 62.8%, p < 0.001), while the rate of COVID-19 infection was not significantly different between the two groups (82.3% vs. 86.6%, p = 0.051). Patients with rheumatic disease experienced substantially more days of fever following infection (2.87 ± 3.42 vs. 2.18 ± 1.65, p = 0.002) compared to individuals in the control group. The rheumatic patients had a greater prevalence of cough (67.1% vs. 54.0%, p < 0.001), somnipathy (13.8% vs. 6.0%, p < 0.001), and conjunctivitis/ophthalmodynia (5.3% vs. 2.1%, p = 0.008), while dry throat/throat pain/weakness (49.9% vs. 59.4%, p = 0.003), myalgia/osteodynia (33.3% vs. 41.8%, p = 0.003), and dyspnea (14.0% vs. 25.3%, p < 0.001) were more likely to occur in non-rheumatic group after infection. Human immunoglobulin (2.1% vs. 0.2%, p = 0.006), glucocorticoids (19.5% vs. 1.6%, p < 0.001), oxygen support (6.8% vs. 2.1%, p < 0.001), and traditional Chinese medicine (21.9% vs. 16.6%, p = 0.037) were all more frequently used by rheumatic patients with COVID-19 infection. People in the control group were more confused about whether to use masks in following social activities after contracting COVID-19 (14.7% vs. 7.6%, p = 0.001). In the control group, more individuals than patients with rheumatic disease (25.1% vs. 13.4%, p < 0.001) expressed an interest to receive the vaccine again. After being exposed to COVID-19, the majority of rheumatic patients (66.9%) reported no discernible change, only 29.1% reported a worsening of their symptoms, and the remaining 4% indicated an improvement. After the COVID-19 outbreak in China, the proportion of patients with rheumatic diseases infected with the virus was similar to that of normal individuals. But the clinical symptoms, follow-up treatment requirements, and awareness of the COVID-19 among rheumatic patients were distinct from those among non-rheumatic patients, necessitating the use of individualized diagnosis and treatment plans as well as health advice by medical professionals in clinical work. Key Points • Despite there were different comorbidities and vaccination rates, the rate of COVID-19 infection in patients with rheumatic disease was similar to that of normal individuals. • After COVID-19 infection, rheumatic patients and normal controls had different clinical symptoms and drug usage. • After being exposed to COVID-19, the majority of rheumatic patients felt no significant change in the primary disease, while the normal controls was more likely to accept a new vaccine injection and confused about whether to use masks in following social activities.

Conformity behavior in crises: evidence from the COVID-19 epidemic in China.

Once a mass health crisis breaks out, it causes concern among whole societies. Thus, understanding the individual's behavior in response to such events is key in government crisis management. From the perspective of social influence theory, this study adopts the empirical research method to collect data information in February 2020 through online survey, with a view to comprehensively describe the individuals'conformity behavior during the COVID-19 outbreak in China. The individual's conformity behavior and new influencing factors were identified. The results revealed that affective risk perception, cognitive risk perception, and individual risk knowledge had a positive significant impact on normative influence. Affective risk perception and individual risk knowledge had a positive significant on informative influence. Cognitive risk perception did not significantly impact informative influence. Informative influence and normative influence had a positive effect on conformity behavior. These results have significant implications for the management behavior of the government.

Surveillance and Outcomes of Pediatric Hematopoietic Stem Cell Transplantation Recipients During the Recent COVID-19 Outbreak in China

Surveillance and Outcomes of Pediatric Hematopoietic Stem Cell Transplantation Recipients During the Recent COVID-19 Outbreak in China

Both people living in the COVID-19 epicenter and those who have recently left are at a higher risk of loneliness

There is little empirical data on the heightened risk of loneliness among individuals residing in the COVID-19 epicenter or those who have recently left. This study compared the risk of loneliness in individuals residing in Wuhan, the COVID-19 epicenter in China, and those who had recently left during the initial outbreak period to those living in non-epicenter regions. During the COVID-19 outbreak in China in 2020, three samples were obtained using snowball sampling. The samples included 2882 epicenter residents, 1028 left residents, and 2963 non-epicenter residents. Loneliness was assessed using the six-item De Jong Gierveld Loneliness Scale, with a score of two or more indicating the presence of loneliness. 53.5% and 55.2% of epicenter and recently left residents, respectively, experienced loneliness, which was significantly higher than the 43.9% observed in non-epicenter residents. After adjusting for covariates, the risk of loneliness remained statistically significant for both epicenter and left residents (OR = 1.35, P < 0.001 and OR = 1.20, P = 0.017, respectively), when compared to non-epicenter residents. Individuals residing in the COVID-19 epicenter, as well as those who have recently left, are at a heightened risk of loneliness during the outbreak. These individuals need psychosocial support to mitigate their risk of loneliness and promote their psychological wellbeing.

The second dose of COVID-19 vaccine booster hesitancy among health care workers in China: A multicenter cross-sectional study

The COVID-19 outbreak in China exposed health care workers (HCWs) to an increased risk of infection. The acquired immunity rapidly diminishes after the previous COVID-19 vaccination and the second booster vaccination has been recommended in several countries. HCWs are a priority group for vaccination because they are at increased risk of being infected, however, a certain amount of HCWs were hesitant. The survey was conducted among 5805 HCWs in China from January 5 to February 9, 2023. Questionnaire included sociodemographic information, COVID-19-related variables, psychological factors, and the COVID-19 vaccine hesitancy scale. Multiple logistic regression analysis was used to assess the influencing factors of the second dose of COVID-19 vaccine booster hesitancy. 42.2% of HCWs self-reported having the second dose of COVID-19 vaccine booster hesitancy. Occupations, years of working, COVID-19 infection status were associated with less vaccine hesitancy. HCWs who had received 3 doses of COVID-19 vaccine were less likely to be hesitant compared to those had not received. HCWs with PTSD symptoms and anxiety symptoms were more likely to be hesitant. No relation was observed between COVID-19 vaccine booster hesitancy and age, marriage, salary, and perceived an increased risk of COVID-19 infection due to work (all P>0.05). A considerable proportion of HCWs were hesitant to accept the second dose of the COVID-19 booster vaccine. Incorporating vaccine knowledge and new evidence into routine health educations and procedures to raise confidence and reduce complacency may be effective and feasible in promoting the vaccination and implementing future vaccination programs.