Early Phase Of COVID-19 Research Articles

Elderly mobility during the COVID-19 pandemic: A qualitative exploration in Kunming, China

The outbreak of COVID-19 in China started at the end of December 2019. This led to a series of containment measurements to control the spread of COVID-19. Despite of the widely reported effects of these measures, inadequate attention has gone to their social impacts. The elderly, as one of the most susceptible populations, has experienced a considerable reduction in mobility.This paper explores the role mobility played and how the social environment influenced elderly mobility in the first 2 months of the COVID-19 outbreak. We surveyed 186 families with a total of 248 elderly people in Kunming. The results show that mobility improves the quality of daily living, such as access to grocery shopping, maintenance of outdoor activities for health cultivation and preserving social networks even during the pandemic. Four themes relating to social environment emerged from the data as elements influencing elderly mobility during the pandemic: social pressure, practice of the virtue of Xiao, the social norm of respecting the aged and the impacts of technological advances. Among them, the virtue of Xiao enabled the elderly to stay in place in the early phase of COVID-19 by fulfilling their needs for daily necessities and social interactions, whilst being less technology-savvy further excluded them socially by restraining them from restoring mobility after the lifting of travel restrictions.

Market challenges for local specialty crop producers during the early phase of COVID-19 in North Carolina

In March of 2020, as the number of COVID-19 cases increased in North Carolina (NC), the state encouraged people to stay at home; this included closing restaurants and canceling large events, as well as reducing the number of people gathering. The economic and health crises created by COVID-19 forced specialty crop producers who sell to local markets, such as restaurants and institutions, to pivot their marketing plans as the growing season began to ramp up. This article reports the responses to the first in a series of producer surveys assessing the impact of the economic and health crises on crop production, market channels, and producer concerns during one of the most insecure times in modern history. Results show that producers who could pivot their marketing plans mostly increased sales through online channels and farm stands. However, almost 50% of the usual market channels were reported to be closed due to COVID-19. Additionally, most producers voiced concerns about economic and health safety in the immediate future. To address these concerns as the pandemic unfolded, there was a need for trusted information. Respondents reported that they rely on Extension and other government agencies for this information and updates regarding the pandemic. This survey captured the early impacts of the COVID-19 pandemic on the specialty crop-producing industry in NC. Additional surveys will provide information on how the pandemic evolved during 2020.

Cross-reactive humoral immune responses against seasonal human coronaviruses in COVID-19 patients with different disease severities

Background: The cross-reactive antibody response against seasonal human coronaviruses (HCoVs) was evaluated according to disease severity in patients with COVID-19 in Japan.Methods: In total, 194 paired serum samples collected from 97 patients with COVID-19 (mild, 35; severe, 62) were analyzed on admission and during convalescence. IgG antibodies against the nucleocapsid (N) and spike (S) proteins of SARS-CoV-2 and four seasonal HCoVs (HCoV-NL63, -229E, -OC43, and -HKU1) were detected by enzyme-linked immunosorbent assays.Results: There was no difference in optical density (OD) values for seasonal HCoVs on admission between the severe and mild cases. In addition, a specific pattern of disease severity-associated OD values for HCoVs was not identified. Significant increases in OD values from admission to convalescence for HCoV-HKU1and -OC43 IgG-S, and for HCoV-NL63 and -229E IgG-N were observed in the severe cases. Significant differences were observed between the mild and severe cases for HCoV-HKU1 and -OC43 IgG-S OD values during convalescence. Correlations were found between the fold changes for HCoV-OC43 IgG-S OD values, and for SARS-CoV-2 IgG-S OD values, and C-reactive protein, lactate dehydrogenase, and lymphocyte levels.Conclusion: There was no association between the antibody titer for seasonal HCoVs in the early phase of COVID-19 and disease severity.

Exploring the STEP-uP to practice: A survey of UK Lead Midwives for Education views of the STudent midwife Extended Practice Placement during the first wave of the COVID-19 pandemic

Objectiveto assess the effect of implementation of the extended placement option available to midwifery students during the first wave of the COVID-19 pandemic. DesignOnline survey open from 2nd June 2020 to 15th July 2020. SettingUnited Kingdom. ParticipantsLead Midwives for Education (LMEs). FindingsA total of 38 of 55 LMEs responded (response rate 69%). The majority of Approved Education Institutions (AEIs) offered an extended placement to students, but with some variation in the choices offered, unrelated to geographical location or size of student cohort. AEIs appeared to provide the majority of decisional support for students. Many practice learning environments became unavailable, particularly community, gynaecology/medical wards and neonatal units. LMEs experienced both internal and external pressures to instigate rapid change. Key conclusionsThe impact of COVID-19 on midwifery education is significant and will need continual scrutiny to minimise future detriment. The pressures of providing midwifery education throughout the early phase of COVID-19 were substantial, but it is important that we learn from the immediate changes made, value and pursue the changes that have been beneficial, and learn from those that were not. Implications for Practice/ResearchStudent learning experiences have undergone significant change during the pandemic. It is essential to assess what effect the extended placement has had on student readiness for practice, their confidence, resilience, mental health, and attrition and retention. Educators transitioned to remote working, and rapidly assimilated new skills for online education; exploration of the impact of this is recommended.

Stress, Anxiety, and Depression Among Undergraduate Students during the COVID-19 Pandemic and their Use of Mental Health Services.

The coronavirus 2019 (COVID-19) has brought significant changes to college students, but there is a lack of empirical studies regarding how the pandemic has affected student mental health among college students in the U.S. To fill the gap in the literature, this study describes stress, anxiety, and depression symptoms for students in a public research university in Kentucky during an early phase of COVID-19 and their usage of mental health services. Results show that about 88% of students experienced moderate to severe stress, with 44% of students showing moderate to severe anxiety and 36% of students having moderate to severe depression. In particular, female, rural, low-income, and academically underperforming students were more vulnerable to these mental health issues. However, a majority of students with moderate or severe mental health symptoms never used mental health services. Our results call for proactively reaching out to students, identifying students at risk of mental health issues, and providing accessible care.

Patterns of Psychological Responses among the Public during the Early Phase of COVID-19: A Cross-Regional Analysis.

This study aimed to compare the mediation of psychological flexibility, prosociality and coping in the impacts of illness perceptions toward COVID-19 on mental health among seven regions. Convenience sampled online survey was conducted between April and June 2020 from 9130 citizens in 21 countries. Illness perceptions toward COVID-19, psychological flexibility, prosociality, coping and mental health, socio-demographics, lockdown-related variables and COVID-19 status were assessed. Results showed that psychological flexibility was the only significant mediator in the relationship between illness perceptions toward COVID-19 and mental health across all regions (all ps = 0.001–0.021). Seeking social support was the significant mediator across subgroups (all ps range = <0.001–0.005) except from the Hong Kong sample (p = 0.06) and the North and South American sample (p = 0.53). No mediation was found for problem-solving (except from the Northern European sample, p = 0.009). Prosociality was the significant mediator in the Hong Kong sample (p = 0.016) and the Eastern European sample (p = 0.008). These findings indicate that fostering psychological flexibility may help to mitigate the adverse mental impacts of COVID-19 across regions. Roles of seeking social support, problem-solving and prosociality vary across regions.

Delayed Parosmia Following SARS-CoV-2 Infection: a Rare Late Complication of COVID-19.

In this report, we present two cases of delayed parosmia, a rare complication that occurs in the late period after COVID-19. A 28-year-old male and a 32-year-old female, found to be positive in rRT-PCR tests for SARS-CoV-2, had a loss of taste and smell, respectively. Following the regaining of their ability to smell after 87 and 72 days, respectively, the male patient reported that the smell he perceived felt the smell of burnt rubber, while the female patient stated that it was similar to the smell of onion. As a result of evaluations, a diagnosis of delayed parosmia was made occurring in the late period secondary to SARS-CoV-2 infection. Although anosmia is a common symptom in the early phase of COVID-19, olfactory damage due to Sars-CoV-2 can be persistent, and distorted sense of smell can be prolonged.

Health-related quality of life of patients with haematologic cancer during COVID-19 and their opinions on telehealth consultations – a Danish single site cross-sectional survey

Introduction During the COVID-19 pandemic, high-risk patient groups might have practiced social distancing and sheltering, and hospitals may have changed or postponed treatments and examinations. We aimed to explore health-related quality of life (QoL) in patients with haematological diseases during the early phase of the pandemic and their acceptability of using telehealth. Patients and methods We performed a cross-sectional survey among patients at the Department of Haematology, Odense University Hospital, Denmark. Eligible participants were patients receiving either active treatment or survivors in a follow-up program. The survey was open from 22 May to 13 June 2020. The survey contained questions on concerns and the impact of COVID-19 and acceptability on telehealth in addition to the assessment of health-related QoL. The later was assessed by the European Organisation for Research and Treatment of Cancer core QoL (EORTC QLQ-C30) questionnaire with the subdomains Global QoL, emotional functioning (EF) and social functioning (SF) being of primary interest. Further, anxiety during COVID-19 was assessed by use of an adapted version of the generalised anxiety disorder (GAD-7) questionnaire. Results 4420 patients were eligible to participate. The response rate was 53% (n = 2239) of which 37% where in a treatment program and 63% where in a follow-up program. The majority (80%) of patients were concerned about contracting COVID-19. The global QoL score (69.0, ±SD 22.6) was markedly lower than EF (84.5, ±SD 18.9) and SF (85.0, ±SD 23.4). Regression analysis showed that being concerned (a little, moderately, very, extremely) about contracting COVID-19 correlated with lower scores of global QoL (−3.86 to −22.76), EF (−3.81 to −26.41) and SF (−1.14 to −22.49). The GAD-7 score showed that approximately 20% of patients had symptoms of COVID-19 associated generalised anxiety. Finally, 67% of the patients were positive towards replacing face-to-face consultancies with phone calls, but video consultations were less preferred (47%). Conclusion Danish patients with haematological cancer presented with low global QoL during the early phase of COVID-19, and 20% of the patients showed symptoms of generalised anxiety. Patients were overall positive towards the implementation of telehealth consultancies.

Interleukin-1 and interleukin-6 inhibition in patients with COVID-19 and hyperinflammation - Authors' reply.

Interleukin-1 and interleukin-6 inhibition in patients with COVID-19 and hyperinflammation - Authors' reply.

Improving Mood Through Community Connection and Resources Using an Interactive Digital Platform: Development and Usability Study

BackgroundCOVID-19 continues to disrupt global health and well-being. In April-May 2020, we generated a digital, remote interactive tool to provide health and well-being resources and foster connectivity among community members through a text messaging platform.ObjectiveThis study aimed to prospectively investigate the ability of a health system–based digital, remote, interactive tool to provide health and well-being resources to local community participants and to foster connectivity among them during the early phases of COVID-19.MethodsWe performed descriptive and nonparametric longitudinal statistical analyses to describe and compare the participants’ mood ratings over time and thematic analysis of their responses to text messages to further assess mood.ResultsFrom among 393 individuals seeking care in an urban emergency department in an academic setting, engaged in a two-way text messaging platform, we recorded 287 mood ratings and 368 qualitative responses. We observed no difference in the initial mood rating by week of enrollment [Kruskal-Wallis chi-square H(5)=1.34; P=.93], and the average mood rating did not change for participants taken together [Friedman chi-square Q(3)=0.32; P=.96]. However, of participants providing mood ratings at baseline, mood improved significantly among participants who reported a low mood rating at baseline [n=25, 14.97%; Q(3)=20.68; P<.001] but remained stable among those who reported a high mood rating at baseline [n=142, 85.03%; Q(3)=2.84; P=.42]. Positive mood elaborations most frequently included words related to sentiments of thankfulness and gratitude, mostly for a sense of connection and communication; in contrast, negative mood elaborations most frequently included words related to anxiety.ConclusionsOur findings suggest the feasibility of engaging individuals in a digital community with an emergency department facilitation. Specifically, for those who opt to engage in a text messaging platform during COVID-19, it is feasible to assess and respond to mood-related queries with vetted health and well-being resources.

The Relation of Threat Level and Age With Protective Behavior Intentions During Covid-19 in Germany.

To contain the spread of Covid-19, engagement in protective behaviors across the population is of great importance. The present study investigated protective behavior intentions during the early phases of Covid-19 in Germany (February 2–April 3, 2020) as a function of threat level and age using data from 4,940 participants in the EUCLID project. Results indicated that the intention to engage in social distancing increased sharply with threat level. Intentions for personal hygiene also increased, although to a lesser extent. While age only had a small overall effect on behavioral intentions, differential patterns emerged. After the lockdown was introduced, the impact of age decreased for social distancing and hygiene behavior intentions but increased for seeing a doctor. Since containing the Covid-19 pandemic depends on high adoption rates of protective behaviors, future research should track sustained phases of the pandemic, including the easing of restrictions and possible new waves of infections.

Mathematical modeling of intervention and low medical resource availability with delays: Applications to COVID-19 outbreaks in Spain and Italy.

Infectious diseases have been one of the major causes of human mortality, and mathematical models have been playing significant roles in understanding the spread mechanism and controlling contagious diseases. In this paper, we propose a delayed SEIR epidemic model with intervention strategies and recovery under the low availability of resources. Non-delayed and delayed models both possess two equilibria: the disease-free equilibrium and the endemic equilibrium. When the basic reproduction number $ R_0 = 1 $, the non-delayed system undergoes a transcritical bifurcation. For the delayed system, we incorporate two important time delays: $ \tau_1 $ represents the latent period of the intervention strategies, and $ \tau_2 $ represents the period for curing the infected individuals. Time delays change the system dynamics via Hopf-bifurcation and oscillations. The direction and stability of delay induced Hopf-bifurcation are established using normal form theory and center manifold theorem. Furthermore, we rigorously prove that local Hopf bifurcation implies global Hopf bifurcation. Stability switching curves and crossing directions are analyzed on the two delay parameter plane, which allows both delays varying simultaneously. Numerical results demonstrate that by increasing the intervention strength, the infection level decays; by increasing the limitation of treatment, the infection level increases. Our quantitative observations can be useful for exploring the relative importance of intervention and medical resources. As a timing application, we parameterize the model for COVID-19 in Spain and Italy. With strict intervention policies, the infection numbers would have been greatly reduced in the early phase of COVID-19 in Spain and Italy. We also show that reducing the time delays in intervention and recovery would have decreased the total number of cases in the early phase of COVID-19 in Spain and Italy. Our work highlights the necessity to consider the time delays in intervention and recovery in an epidemic model.

Employment and income support policies during the early phases of COVID-19: Lessons from the U.S., Denmark, and Taiwan

As COVID-19 spread across the world in 2020, health and economic activities have been impacted, and unemployment has risen across many countries. The consequences have been particularly harmful to vulnerable populations such as women, racial minorities, or part-time workers. While many governments enacted employment and income support policies as a response to this economic and health crisis, there has been a lack of comparative and evaluative reviews of how policies have addressed unemployment and inequality during the pandemic. In this study, we draw on Esping-Andersen’s (1990) frame of a liberal versus social-democratic welfare state to contextualize some employment and income support polices during the early phases of COVID-19 from the U.S., Denmark, and Taiwan, aiming to enhance the understanding of such policies. We found that the U.S., being more aligned with a liberal welfare state regime, relied on more market mechanisms to address labor and employment issues. Denmark and Taiwan, being more aligned with a social-democratic welfare state, enacted more interventions in and redistributions outside of the market to address employment problems. The human costs of unemployment and unemployment and labor market hysteresis are addressed in light of these two different approaches and outcomes.

Micro, mezzo, and macro factors associated with coping in the early phase of COVID-19

ABSTRACT Coping and adapting to crisis can be influenced by numerous factors on multiple levels. The experience during the beginning of the COVID-19 pandemic is no different. This article reports on the results of a cross-sectional, online survey administered to adults living in the United States and Canada in June 2020 (N = 1,405). Hierarchical multiple regression analysis found that respondent’s age, support of family and friends, support of children’s school, use of alcohol and substances, level of trust/satisfaction with national government, being overwhelmed by the amount of COVID-related information, and level of life disruption accounted for 12% of the variance for level of self-reported coping. This study did not find that race or gender impacted self-reported coping. Discussion and implications at the micro, mezzo and macro levels are offered.

Chest radiographs may assist in predicting the outcome in the early phase of Covid-19. UK district general hospital experience of Covid-19 first wave

ABSTRACT Objectives: Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has caused enormous strain on health-care systems worldwide. Early recognition of prognostic markers and appropriate management of patients with coronavirus disease 2019 (Covid-19) remains a major global health concern, particularly when resources are limited. We undertook a study to see if basic tests can inform frontline clinicians of disease trajectory in individual patients with COVID-19. Methods: We retrospectively assessed characteristics of the first 50 consecutive patients admitted to district general hospital in the United Kingdom with positive SARS-Cov-2 RNA swabs. Results: Our patient cohort shared broad similarities with previously published data on comorbidities and presenting features. We have found that chest radiographic assessment differed between survivors and non-survivors. Air space shadowing in middle zones were more prevalent in non-survivors (73.3% vs. 35.5% [p = 0.027]). Chest radiograph severity score was also found to be higher in non-survivors compared to survivors (3 vs. 1.5 [p = 0.007]). Conclusions: In this small retrospective study, our results suggest features of chest radiographs at presentation may provide a helpful tool for prognostication. In environments with constrained computed tomography (CT) imaging with serial chest radiographs could be a cost-effective tool in the assessment of Covid-19 patients.

Psychobehavioral Responses, Post-Traumatic Stress and Depression in Pregnancy During the Early Phase of COVID-19 Outbreak.

ObjectiveThe novel coronavirus disease (COVID‐19) outbreak has aroused a range of negative effects. Such considerable influence can be greater in vulnerable populations including pregnant women. This study aimed to assess the presence of prenatal depression (PND, as an important risk factor of postpartum depression) and post‐traumatic stress disorder (PTSD) and to characterize infection‐induced preventive behaviors and psychological responses in the early phase of COVID‐19 outbreak.MethodsBased on a population‐based sample of pregnant women from all regions in China, presence of probable PND and suspected PTSD were assessed using the Edinburgh Postnatal Depression Scale (≥13) and the PTSD Checklist (≥14), respectively. A web‐based questionnaire was used to assess psychological and behavioral responses to COVID‐19.ResultsAmong a total of 1908 questionnaires returned, 1901 women provided valid data (mean [SD] age, 28.9 [4.7] years). High prevalence of probable PND (34%) and suspected PTSD (40%) among pregnant women was observed. Those with suspected PTSD presented six times higher risk of probable PND than the non‐suspected (OR=7.83, 95% CI: 6.29–9.75; p<0.001). Most women (91%–96%) reported anxiousness about infection of themselves and the members within their social network. Lack of security and loss of freedom were reported in approximately two‐thirds of pregnant women. More frequent preventive behaviors, including handwashing, use of facemasks, and staying at home, were undertaken in more than 80% of the sample. Anxiousness of miscarriage and preterm birth were prevalent (>75%).ConclusionsHigh prevalence of PND and PTSD and high levels of anxiety suggest profound impacts of the present outbreak on mental health. This calls for special attention and support for vulnerable populations. Mental health care should become part of public health measures during the present outbreak and should continue to be intensified to empower the health system for post‐outbreak periods.

Civic capital and social distancing during the Covid-19 pandemic☆

Using mobile phone and survey data, we show that during the early phases of COVID-19, voluntary social distancing was greater in areas with higher civic capital and amongst individuals exhibiting a higher sense of civic duty. This effect is robust to including controls for political ideology, income, age, education, and other local-level characteristics. This result is present for U.S. individuals and U.S. counties as well as European regions. Moreover, we show that after U.S. states began re-opening, high civic capital counties maintained a more sustained level of social distancing, while low civic capital counties did not. Finally, we show that U.S. individuals report a higher tendency to use protective face masks in high civic capital counties. Our evidence points to the importance of considering the level of civic capital in designing public policies not only in response to pandemics, but also more generally.

Changes in Alcohol and Cannabis Retail Sales in Canada During the Early Phase of COVID-19

Background: Changes in the use of alcohol and other substances during COVID-19 is of considerable public health interest. This study examined changes in per capita alcohol, cannabis and other essential retail sales across Canada during the early phase of COVID-19, and associations between these changes and different jurisdictional approaches to drug control.Methods: A time series analysis was used to examine trends in monthly per capita alcohol, cannabis, and essential and non-essential retail sales before and during the first three months of COVID-19 for 12 jurisdictions across Canada. We compared observed sales during the first three months of COVID-19 to predicted sales based on model outputs using pre-COVID-19 trends. Next, we used difference in difference models to estimate the associations between different models of alcohol and cannabis retail systems and changes in retail sales during COVID-19.Findings: In Canada, observed per capita sales were significantly greater than predicted for alcohol (+9.6%) and cannabis (+14.1%) during March 2020, and consistent with predicted sales in April and May 2020. Essential retail sales were significantly less than predicted during March to May 2020 (average of -7.4%). During COVID-19, per capita alcohol sales in jurisdictions with a private retail system increased significantly (+$8.5 on average, 95%CIs; 2.1,15.6) after accounting for changes over time. In contrast, the relative change in per capita alcohol sales in jurisdictions with a public retail model prior to and during COVID-19 was, on average, $13.3 lower (95% CIs; -22.6,-4.0) compared to the changes in jurisdictions with a private retail model. Similar trends were observed for cannabis sales with respect to retail model.Interpretation: There was a modest increase in alcohol and cannabis purchasing during the first three months of COVID-19. Changes in sales were influenced by pre-existing policies, and jurisdictions with a private retail model had greater than expected alcohol and cannabis sales compared to jurisdictions with a public model. This study adds to the body of research showing that government-run retail models for alcohol and cannabis provide protection for public health.Funding Statement: There is no funding to disclose for this project. Declaration of Interests: The authors have all completed ICMJE conflict of interest forms. The authors have no conflicts of interest to declare.Ethics Approval Statement: This project was approved by the Public Health Ontario Ethics Review Board file number 2020-038.01.

Tourism under the Early Phase of COVID-19 in Four APEC Economies: An Estimation with Special Focus on SARS Experiences.

This study examines how experience of severe acute respiratory syndrome (SARS) influences the impact of coronavirus disease (COVID-19) on international tourism demand for four Asia-Pacific Economic Cooperation (APEC) economies, Taiwan, Hong Kong, Thailand, and New Zealand, over the 1 January–30 April 2020 period. To proceed, panel regression models are first applied with a time-lag effect to estimate the general effects of COVID-19 on daily tourist arrivals. In turn, the data set is decomposed into two nation groups and fixed effects models are employed for addressing the comparison of the pandemic-tourism relationship between economies with and without experiences of the SARS epidemic. Specifically, Taiwan and Hong Kong are grouped as economies with SARS experiences, while Thailand and New Zealand are grouped as countries without experiences of SARS. The estimation result indicates that the number of confirmed COVID-19 cases has a significant negative impact on tourism demand, in which a 1% COVID-19 case increase causes a 0.075% decline in tourist arrivals, which is a decline of approximately 110 arrivals for every additional person infected by the coronavirus. The negative impact of COVID-19 on tourist arrivals for Thailand and New Zealand is found much stronger than for Taiwan and Hong Kong. In particular, the number of tourist arrivals to Taiwan and Hong Kong decreased by 0.034% in response to a 1% increase in COVID-19 confirmed cases, while in Thailand and New Zealand, a 1% national confirmed cases increase caused a 0.103% reduction in tourism demand. Moreover, the effect of the number of domestic cases on international tourism is found lower than the effect caused by global COVID-19 mortality for the economies with SARS experiences. In contrast, tourist arrivals are majorly affected by the number of confirmed COVID-19 cases in Thailand and New Zealand. Finally, travel restriction in all cases is found to be the most influencing factor for the number of tourist arrivals. Besides contributing to the existing literature focusing on the knowledge regarding the nexus between tourism and COVID-19, the paper’s findings also highlight the importance of risk perception and the need of transmission prevention and control of the epidemic for the tourism sector.

Can Beta-2-Adrenergic Pathway Be a New Target to Combat SARS-CoV-2 Hyperinflammatory Syndrome?-Lessons Learned From Cancer.

SARS-CoV-2 infection is a new threat to global public health in the 21st century (2020), which has now rapidly spread around the globe causing severe pneumonia often linked to Acute Respiratory Distress Syndrome (ARDS) and hyperinflammatory syndrome. SARS-CoV-2 is highly contagious through saliva droplets. The structural analysis suggests that the virus enters human cells through the ligation of the spike protein to angiotensin-converting enzyme 2 (ACE2). The progression of Covid-19 has been divided into three main stages: stage I—viral response, stage II—pulmonary phase, and stage III—hyperinflammation phase. Once the patients enter stage III, it will likely need ventilation and it becomes difficult to manage. Thus, it will be of paramount importance to find therapies to prevent or slow down the progression of the disease toward stage III. The key event leading to hyperinflammation seems to be the activation of Th-17 immunity response and Cytokine storm. B2-adrenergic receptors (B2ARs) are expressed on airways and on all the immune cells such as macrophages, dendritic cells, B and T lymphocytes. Blocking (B2AR) has been proven, also in clinical settings, to reduce Th-17 response and negatively modulate inflammatory cytokines including IL-6 while increasing IFNγ. Non-selective beta-blockers are currently used to treat several diseases and have been proven to reduce stress-induced inflammation and reduce anxiety. For these reasons, we speculate that targeting B2AR in the early phase of Covid-19 might be beneficial to prevent hyperinflammation.