Wuhan Residents Research Articles

Seroprevalence of SARS-CoV-2 immunoglobulin antibodies in Wuhan, China: part of the city-wide massive testing campaign

ObjectivesThe outbreak of the 2019 coronavirus disease (COVID-19) pandemic in Wuhan, China, has subsided after being hard hit by the disease and subsequent city lockdown. Information on the number of people involved in Wuhan is still inadequate. This study aimed to describe the screening results of 61 437 community members in Wuchang District, Wuhan. MethodsIn mid-May 2020, Wuhan launched a population-scale city-wide SARS-CoV-2 testing campaign, which aimed to perform nucleic acid and viral antibody testing for citizens in Wuhan. Here we show the screening results of cluster sampling of 61 437 residents in Wuchang District, Wuhan, China. ResultsA total of 1470 (2.39%, 95% CI 2.27–2.52) individuals were detected positive for at least one antiviral antibody. Among the positive individuals, 324 (0.53%, 95% CI 0.47–0.59) and 1200 (1.95%, 95% CI 1.85–2.07) were positive for immunoglobulin IgM and IgG, respectively, and 54 (0.08%, 95% CI 0.07–0.12) were positive for both antibodies. The positive rate of female carriers of antibodies was higher than those of male counterparts (male-to-female ratio of 0.75), especially in elderly citizens (ratio of 0.18 in 90+ age subgroup), indicating a sexual discrepancy in seroprevalence. In addition, viral nucleic acid detection using real-time PCR had showed 8 (0.013%, 95% CI 0.006–0.026) asymptomatic virus carriers. DiscussionThe seroprevalence of SARS-CoV-2 in Wuhan was low. Most Wuhan residents are still susceptible to this virus. Precautions, such as wearing mask, frequent hand hygiene and proper social distance, are necessary before an effective vaccine or antiviral treatments are available.

Anxiety levels, precautionary behaviours and public perceptions during the early phase of the COVID-19 outbreak in China: a population-based cross-sectional survey

ObjectiveTo investigate psychological and behavioural responses to COVID-19 among the Chinese general population.Design, setting and participantsWe conducted a population-based mobile phone survey between 1 February and 10 February 2020 via...

How did Wuhan residents cope with a 76-day lockdown?

Wuhan, the original epicenter of the COVID-19 outbreak, was under strict lockdown for 76 days. We conducted 30 in-depth interviews to understand Wuhan residents’ lived experiences of lockdown life. We found that despite strong emotions initially, Wuhan residents quickly adapted to life under unprecedented lockdown. We identified three pre-existing structures that facilitated the effective implementation of the massive lockdown: ready-made containment units offered by urban “gated” housing, a comprehensive grassroots governance network coordinated by shequ (community residence committees), and the ubiquitous WeChat app in Chinese daily life. We also showed that the pre-existing structures provided space for uncontentious self-organizing, grassroots mobilization, and civic engagement that often dove-tailed with state-mandated measures. This study details the resources Wuhan residents drew upon to get by during the lockdown, and it illustrates that the feasibility of lockdown measures relies heavily on a society’s structural and institutional conditions.

A COVID-19 descriptive study of life after lockdown in Wuhan, China.

On 8 April 2020, the Chinese government lifted the lockdown and opened up public transportation in Wuhan, China, the epicentre of the COVID-19 pandemic. After 76 days in lockdown, Wuhan residents were allowed to travel outside of the city and go back to work. Yet, given that there is still no vaccine for the virus, this leaves many doubting whether life will indeed go back to normal. The aim of this research was to track longitudinal changes in motivation for self-isolating, life-structured, indicators of well-being and mental health after lockdown was lifted. We have recruited 462 participants in Wuhan, China, prior to lockdown lift between 3 and 7 April 2020 (Time 1), and have followed up with 292 returning participants between 18 and 22 April 2020 (Time 2), 284 between 6 and 10 May 2020 (Time 3), and 279 between 25 and 29 May 2020 (Time 4). This four-wave study used latent growth models to examine how Wuhan residents' psychological experiences change (if at all) within the first two months after lockdown was lifted. The Stage 1 manuscript associated with this submission received in-principle acceptance (IPA) on 2 June 2020. Following IPA, the accepted Stage 1 version of the manuscript was preregistered on the OSF at https://osf.io/g2t3b. This preregistration was performed prior to data analysis. Generally, our study found that: (i) a majority of people still continue to value self-isolation after lockdown was lifted; (ii) by the end of lockdown, people perceived gradual return to normality and restored structure of everyday life; (iii) the psychological well-being slightly improved after lockdown was lifted; (iv) people who used problem solving and help-seeking as coping strategies during lockdown had better well-being and mental health by the end of the lockdown; (v) those who experienced more disruptions in daily life during lockdown would display more indicators of psychological ill-being by the end of the lockdown.

“Psychological Typhoon Eye Effect” and “Ripple Effect”: Double perspective test of risk perception and anxiety characteristics of people in different COVID-19severityregions

<p id="C2">COVID-19 has greatly affected the psychological state of Chinese people. This study carried out a dynamic follow-up survey of the psychological state of Chinese people and their evaluation of Wuhan residents during the epidemic period since the day of Wuhan’s citywide lockdown. The purpose of this work was to explore differences in degree of concern, risk perception, and anxiety response among regions affected by COVID-19 to different degrees. Our findings have important practical value for future crisis emergency management. <p id="C2-1">This work included a large-scale survey covering 4833 Chinese residents, and it was conducted after Wuhan was closed. Its purpose was to assess whether COVID-19 invoked the psychological typhoon eye effect of a disaster event. The survey involved two angles, the “actor” angle, in which participants evaluated their own psychological states, and the “bystander” angle, in which participants evaluated other Wuhan citizens’ psychological states. We called these Study 1 and Study 2. Study1 explored the psychological state of residents themselves and the results were consistent with the ripple effect to some extent within the epidemic period, which is the opposite pattern of the psychological typhoon eye. The residents who lived near the hardest-hit areas showed significantly higher risk perception and anxiety. Study 2 explored how people from different areas evaluated Wuhan residents’ psychological state. The results of Study 2 did show a replicated psychological typhoon eye effect in terms of anxiety, and number of psychological workers and doctors residents needed. However, when it came to risk cognition, residents in low-risk areas rated Wuhan citizens’ risk cognition as significantly lower than people in high-risk areas did, which generally manifested as a ripple effect. <p id="C2-2">This study also showed a marginal zone effect and a psychological controllable threshold. The concave effect means there was a phenomenon in which risk perception was lower in the middle zone or middle-risk area than at either end. The psychological controllable threshold is one of the sub-scales of risk cognition. That is, uncontrollability did not show the psychological typhoon eye effect in the bystander portion of our study. <p id="C2-3">This paper further expands and enriches the boundary conditions of the psychological typhoon eye effect of public risk events, provides more abundant and direct research evidence for the perception difference between actor and bystander angle in the study of psychological typhoon eye effect, and has important implications for a deeper understanding of the psychological evolution of public health emergencies and public crisis management.

The Relationship between Risk Event Involvement and Risk Perception during the COVID-19 Outbreak in China.

BackgroundThe coronavirus disease 2019 (COVID‐19) is a worldwide pandemic that continues to spread and the situation continues to deteriorate globally. It is also a risk event for the public in affected areas. However, little is known about the relationship between “being involved/exposed in a risk event at the moment” and people’s risk perception of that event.MethodsThe mediation model and analysis of covariance method were performed on a Chinese sample (N = 351) during the outbreak of COVID‐19 to test the underlying mechanism between risk event involvement and risk perception.ResultsRisk event involvement was positively related not only to people’s event‐related risk perception but also their general risk perception (i.e. risk perception towards other events), and negative emotion mediated these relationships. In addition, the residents of Wuhan (vs. non‐Wuhan) exhibited significantly higher event‐related risk perception as well as general risk perception.ConclusionsThe findings deepen our understanding of risk perception by suggesting that being involved in a risk event at the moment is also a nonnegligible variable positively related to risk perception through increased negative emotion. Finally, theoretical and managerial implications of the result are discussed.

Mental health toll from the coronavirus: Social media usage reveals Wuhan residents’ depression and secondary trauma in the COVID-19 outbreak

This study investigates the possible association between social media usage and the mental health toll from the coronavirus at the peak of Wuhan's COVID-19 outbreak. Informed by the Crisis and Emergency Risk Communication Model and Health Belief Model, it proposes a conceptual model to study how people in Wuhan – the first epicenter of the global COVID-19 pandemic – used social media and its effects on users' mental health conditions and health behavior change. The results show that social media usage was related to both depression and secondary trauma, which also predicted health behavior change. But no relation was detected between health behavior change and mental health conditions. As the virus struck, social media usage was rewarding to Wuhan people who gained informational, emotional, and peer support from the health information shared on social media. An excessive use of social media, however, led to mental health issues. The results imply that taking a social media break may promote well-being during the pandemic, which is crucial to mitigating mental health harm inflicted by the pandemic.

Assessment for personal PM2.5 exposure with a modeling method: A panel study in Wuhan, China

The adverse health effects from fine particulate matter (PM2.5) exposure have attracted much attention. However, the method to evaluate individual PM2.5 exposure levels in large populations has always been a challenging task. We conducted this study to explore the relationships of ambient PM2.5, meteorological conditions and personal lifestyles with personal PM2.5 exposure and establish an estimated model for personal PM2.5 exposure among community residents in Wuhan. Participants were extracted from Wuhan-Zhuhai cohort and a total of 191 24-h personal PM2.5 measurements were conducted using personal PM2.5 samplers in Spring, 2014, 2017. Ambient PM2.5 concentration, meteorological conditions and personal lifestyles were collected from the nearest fixed air monitoring station, meteorological station and face-to-face investigation, respectively. The average concentration of daily personal PM2.5 exposure was 156.85 μg/m3 with a range of 14.85–443.21 μg/m3 in this study, which was almost twice as high as the ambient PM2.5 concentrations (average 71.16 μg/m3). After stepwise selection and linear mixed model fitting, ambient PM2.5, cigarette consumption, passive smoking, pressure difference, temperature, relative humidity, and wind speed were selected into the final model. Marginal R2 and conditional R2 of this model were 0.604 and 0.635, respectively. R2 of 10-fold cross validation was 0.654. This study provided an estimated model with relatively comprehensive consideration of sources for personal PM2.5 exposure in Wuhan.

Understanding consumer behavior patterns in antibiotic usage for upper respiratory tract infections: A study protocol based on the COM-B framework.

Irrational use of antibiotics is prevalent worldwide. But our understanding on consumer behaviors in the use of antibiotics is very limited. This study aims to identify consumer behavior patterns in the use of antibiotics for upper respiratory tract infections (URTIs). The study will employ a mixed methods approach based on the "Capacity & Opportunity & Motivation - Behavior" (COM-B) framework. The COM-B attributes of consumers in relation to the use of antibiotics will be extracted from a systematic literature review. Semi-structured in-depth interviews will be conducted on 20-25 community residents with URTI symptoms over the past three months to illustrate the meaning and implications of the thematic categories of COM-B attributes for the purpose of measurement development. The measurement instruments will be modified and validated through Delphi consultations with 15 experts and a survey of 300 adult residents in Wuhan. A cross-sectional survey using the finalised measurement instruments will be conducted on 2700 adult residents randomly selected from 18 residential communities across 9 municipalities in 3 provinces in China. Multi-level latent class analyses will be performed to categeorise the respondents based on the indicators measuring the behavioral features (need recognition, information searching, alternative assessment, purchase, use, and post-use evaluation) of consumers in purchasing, consuming and disposing antibiotics for URTIs. Multi-nominal regression analyses will be performed to determine the predictors of different behavior patterns. This study aims to classify consumers into distinguished categories of behavior patterns toward the use of antibiotics for URTIs. Such a classification system categories the consumers with similar behavior features into the same group so that better targeted interventions can be developed. The COM-B model adopted in this study can also help us better understand the underlying mechanisms of different behavior patterns of consumers.

Psychological health, sleep quality, and coping styles to stress facing the COVID-19 in Wuhan, China

To understand Wuhan residents’ psychological reactions to the COVID-19 epidemic and offer a reference point for interventions, an online questionnaire survey was conducted. It included the Disorder 7-Item Scale (GAD-7), the Patient Health Questionnaire 9-Item Scale (PHQ-9), Athens Insomnia Scale, and Simplified Coping Style Questionnaire. Categorical data were reported as numbers and percentages. Multivariate logistic regression models were used to evaluate the association between demographic factors and anxiety, depression, sleep disorder, and passive coping style. A total of 1242 Wuhan residents investigated, 27.5% had anxiety, 29.3% had depression, 30.0% had a sleep disorder, and 29.8% had a passive response to COVID-19. Being female was the risk factor for anxiety (OR = 1.62) and sleep disorder (OR = 1.36); being married was associated with anxiety (OR = 1.75); having a monthly income between 1000 and 5000 CNY (OR = 1.44, OR = 1.83, OR = 2.61) or >5000 CNY (OR = 1.47, OR = 1.45, OR = 2.14) was a risk factor for anxiety, depression, and sleep disorder; not exercising (OR = 1.45, OR = 1.71, OR = 1. 85, OR = 1.71) was a common risk factor for anxiety, depression, sleep disorder, and passive coping style; and having a higher education level (bachelor’s degree and above) (OR = 1.40) was associated with having a sleep disorder. Wuhan residents’ psychological status and sleep quality were relatively poorer than they were before the COVID-19 epidemic; however, the rate of passive coping to stress was relatively higher.

Clinical characteristics of 82 cases of death from COVID-19.

A recently developed pneumonia caused by SARS-CoV-2 bursting in Wuhan, China, has quickly spread across the world. We report the clinical characteristics of 82 cases of death from COVID-19 in a single center. Clinical data on 82 death cases laboratory-confirmed as SARS-CoV-2 infection were obtained from a Wuhan local hospital's electronic medical records according to previously designed standardized data collection forms. All patients were local residents of Wuhan, and a large proportion of them were diagnosed with severe illness when admitted. Due to the overwhelming of our system, a total of 14 patients (17.1%) were treated in the ICU, 83% of deaths never received Critical Care Support, only 40% had mechanical ventilation support despite 100% needing oxygen and the leading cause of death being pulmonary. Most of the patients who died were male (65.9%). More than half of the patients who died were older than 60 years (80.5%), and the median age was 72.5 years. The bulk of the patients who died had comorbidities (76.8%), including hypertension (56.1%), heart disease (20.7%), diabetes (18.3%), cerebrovascular disease (12.2%), and cancer (7.3%). Respiratory failure remained the leading cause of death (69.5%), followed by sepsis/MOF (28.0%), cardiac failure (14.6%), hemorrhage (6.1%), and renal failure (3.7%). Furthermore, respiratory, cardiac, hemorrhagic, hepatic, and renal damage were found in 100%, 89%, 80.5%, 78.0%, and 31.7% of patients, respectively. On admission, lymphopenia (89.2%), neutrophilia (74.3%), and thrombocytopenia (24.3%) were usually observed. Most patients had a high neutrophil-to-lymphocyte ratio of >5 (94.5%), high systemic immune-inflammation index of >500 (89.2%), and increased C-reactive protein (100%), lactate dehydrogenase (93.2%), and D-dimer (97.1%) levels. A high level of IL-6 (>10 pg/ml) was observed in all detected patients. The median time from initial symptoms to death was 15 days (IQR 11-20), and a significant association between aspartate aminotransferase (p = 0.002), alanine aminotransferase (p = 0.037) and time from initial symptoms to death was remarkably observed. Older males with comorbidities are more likely to develop severe disease and even die from SARS-CoV-2 infection. Respiratory failure is the main cause of COVID-19, but the virus itself and cytokine release syndrome-mediated damage to other organs, including cardiac, renal, hepatic, and hemorrhagic damage, should be taken seriously as well.

TINGKAT STRES MAHASISWA S1 KEPERAWATAN TINGKAT SATU DALAM MENGHADAPI WABAH COVID 19 DAN PERKULIAHAN DARING DI STIKES KARYA HUSADA KEDIRI

The Covid-19 outbreak is a new type of disease and is highly contagious. This new virus was previously unknown before infecting many residents of Wuhan, China. This virus is now spreading to most of the world. To prevent its spread, the government urges people to stay at home and learn online. The aimed of this study was to determine the level of stress of first-degree students in the Nursing Study Program at Stikes Karya Husada in dealing with the Covid-10 outbreak and online lectures due to the outbreak. This type of research is a descriptive study with cross sectional design. Sampling was done by purposive sampling technique to get a total sample of 70 respondents. Data were collected using a questionnaire in the form of google and found that most students experienced moderate stress (38.57%), some experienced severe stress (28.57%), and mild stress (32.86%). The stressors that cause the most stress are difficulty understanding online material and worry about contracting Covid-19. Pandemic conditions that are full of uncertainty need to be addressed wisely by various parties. It takes effort to reduce stress by doing a variety of fun activities in the home that can be done by students.&#x0D; Keywords: stress level, students, covid-19, online lectures

Clinical Features of Maintenance Hemodialysis Patients with 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China.

Previous reports on the outbreak of coronavirus disease 2019 were on the basis of data from the general population. Our study aimed to investigate the clinical features of patients on maintenance hemodialysis. In this retrospective, single-center study, we included 49 hospitalized patients on maintenance hemodialysis and 52 hospitalized patients without kidney failure (controls) with confirmed coronavirus disease 2019 at Tongren Hospital of Wuhan University from January 30, 2020 to March 10, 2020. Demographic, clinical, laboratory, and radiologic characteristics and treatment and outcomes data were analyzed. The final date of follow-up was March 19, 2020. The median age of 101 patients was 62 years (interquartile range, 49-72). All patients were local residents of Wuhan. In terms of common symptoms, there were differences between patients on hemodialysis and controls (fatigue [59% versus 83%], dry cough [49% versus 71%], and fever [47% versus 90%]). Lymphocyte counts were decreased (0.8×109/L [patients on hemodialysis] versus 0.9×109/L [controls], P=0.02). Comparing patients on hemodialysis with controls, creatine kinase-muscle and brain type, myoglobin, hypersensitive troponin I, B-type natriuretic peptide, and procalcitonin were increased, and the percentage of abnormalities in bilateral lung was higher in computed tomographic scan (82% versus 69%, P=0.15) and unilateral lung was lower (10% versus 27%, P=0.03). Common complications including shock, acute respiratory distress syndrome, arrhythmia, and acute cardiac injury in patients on hemodialysis were significantly higher. Compared with controls, more patients on hemodialysis received noninvasive ventilation (25% versus 6%, P=0.008). As of March 19, 2020, three patients on hemodialysis (6%) were transferred to the intensive care unit and received invasive ventilation. Seven patients on hemodialysis (14%) had died. The main symptoms of coronavirus disease 2019 pneumonia, including fever and cough, were less common in patients on hemodialysis. Patients on hemodialysis with coronavirus disease 2019 were at higher risk of death.

PC-FACS: COVID-19

PC-FACS (FastArticleCriticalSummaries forClinicians inPalliativeCare) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PCFACS, please encourage them to join the AAHPM at aahpm.org. Comments from readers are welcomed at pcfacs@aahpm.org.

What Is Required to Prevent a Second Major Outbreak of SARS-CoV-2 upon Lifting Quarantine in Wuhan City, China

SummaryBackgroundThe Chinese government implemented a metropolitan-wide quarantine of Wuhan city on 23rd January 2020 to curb the epidemic of the coronavirus COVID-19. Lifting of this quarantine is imminent. We modelled the effects of two key health interventions on the epidemic when the quarantine is lifted.MethodsWe constructed a compartmental dynamic model to forecast the trend of the COVID-19 epidemic at different quarantine lifting dates and investigated the impact of different rates of public contact and facial mask usage on the epidemic.ResultsWe projected a declining trend of the COVID-19 epidemic if the current quarantine strategy continues, and Wuhan would record the last new confirmed cases in late April 2020. At the end of the epidemic, 65,733 (45,722-99,015) individuals would be infected by the virus, among which 16,166 (11,238-24,603, 24.6%) were through public contacts, 45,996 (31,892-69,565, 69.7%) through household contact, and 3,571 (2,521-5,879, 5.5%) through hospital contacts (including 778 (553-1,154) non-COVID-19 patients and 2,786 (1,969-4,791) medical staff). A total of 2,821 (1,634-6,361) would die of COVID-19 related pneumonia in Wuhan. Early quarantine lifting on 21st March is viable only if Wuhan residents sustain a high facial mask usage of ≥85% and a pre-quarantine level public contact rate. Delaying city resumption to mid/late April would relax the requirement of facial mask usage to ≥75% at the same contact rate.ConclusionsThe prevention of a second epidemic is viable after the metropolitan-wide quarantine is lifted but requires a sustaining high facial mask usage and a low public contact rate.

A comparative‐descriptive analysis of clinical characteristics in 2019‐coronavirus‐infected children and adults

Acute respiratory disease caused by 2019 novel coronavirus (2019-nCoV) has rapidly spread throughout China. Children and adults show a different clinical course. The purpose of the current study is to comparatively analyze the clinical characteristics of 2019-nCoV infection in children and adults and to explore the possible causes for the discrepancies present. The medical records of 25 adults and 7 children confirmed cases of 2019-2019-nCoV acute respiratory diseases were reviewed retrospectively. All children were family clusters. The total adult patients were differentiated into the local residents of Wuhan, a history of travel to Wuhan and direct contact with people from Wuhan. The numbers were 14 (56%), 10 (40%), and 1 (4%), respectively. The median incubation period of children and adults was 5 days (ranged, 3-12 days) and 4 days (ranged, 2-12 days), respectively. Diarrhoea and/or vomiting (57.1%) were demic by World Health Organiza more common in children, whereas for adults it was myalgia or fatigue (52%). On admission, the percentage of children having pneumonia (5%, 71.4%) was roughly the same as adults (20%, 80%). A total of 20% of adults had leucopoenia, but leukocytosis was more frequently in children (28.6%, P=.014). A higher number of children had elevated creatine kinase isoenzyme (57.1% vs 4%, P=.004). Antiviral therapy was given to all adult patients but to none of the children. In summary, knowledge of these differences between children and adults will not only be helpful for the clinical diagnosis of2019-nCoV disease, but also for a future discussion on age-specific coronavirus infection.

What is Required to Prevent a Second Major Outbreak of the Novel Coronavirus COVID-19 Upon Lifting the Metropolitan-Wide Quarantine of Wuhan City, China: A Mathematical Modelling Study

Background: The Chinese government implemented a metropolitan-wide quarantine of Wuhan city on 23 rd January 2020 to curb the epidemic of the coronavirus COVID-19. Lifting of this quarantine is imminent. We modelled the effects of two key health interventions on the epidemic when the quarantine is lifted. Method: We constructed a compartmental dynamic model to forecast the trend of the COVID-19 epidemic at different quarantine lifting dates and investigated the impact of different rates of public contact and facial mask usage on the epidemic. Results: We projected a declining trend of the COVID-19 epidemic if the current quarantine strategy continues, and Wuhan would record the last new confirmed cases on 25 th April 2020. At the end of the epidemic, 65,572 (46,156-95,264) individuals would be infected by the virus, among which 16,144 (14,422-23,447, 24.6%) were through public contacts, 45,795 (32,390-66,395, 69.7%) through household contact, and 3,633 (2,344-5,865, 5.5%) through hospital contacts (including 783 (553-1,134) non-COVID-19 patients and 2,850 (1,801-4,981) medical staff). A total of 3,262 (1,592-6,470) would die of COVID-19 related pneumonia in Wuhan. Early quarantine lifting on 21 st March is viable only if Wuhan residents sustain a high facial mask usage of ≥85% and a pre-quarantine level public contact rate. Delaying city resumption to mid/late April would relax the requirement of facial mask usage to ≥75% at the same contact rate. Conclusion: The prevention of a second epidemic is viable after the metropolitan-wide quarantine is lifted but requires a sustaining high facial mask usage and a low public contact rate. Funding Statement: This work is supported by a Research Grant from the Bill & Melinda Gates Foundation. Declaration of Interests: None.

Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter

The outbreak of COVID-19 in China in December 2019 has been identified as a pandemic and a health emergency of global concern. Our objective was to investigate the prevalence and predictors of posttraumatic stress symptoms (PTSS) in China hardest-hit areas during COVID-19 outbreak, especially exploring the gender difference existing in PTSS. One month after the December 2019 COVID-19 outbreak in Wuhan China, we surveyed PTSS and sleep qualities among 285 residents in Wuhan and surrounding cities using the PTSD Checklist for DSM-5 (PCL-5) and 4 items from the Pittsburgh Sleep Quality Index (PSQI). Hierarchical regression analysis and non-parametric test were used to analyze the data. Results indicated that the prevalence of PTSS in China hardest-hit areas a month after the COVID-19 outbreak was 7%. Women reported significant higher PTSS in the domains of re-experiencing, negative alterations in cognition or mood, and hyper-arousal. Participants with better sleep quality or less frequency of early awakenings reported lower PTSS. Professional and effective mental health services should be designed in order to aid the psychological wellbeing of the population in affected areas, especially those living in hardest-hit areas, females and people with poor sleep quality.

Clinical Characteristics of Coronavirus Disease 2019 in China

BackgroundSince December 2019, when coronavirus disease 2019 (Covid-19) emerged in Wuhan city and rapidly spread throughout China, data have been needed on the clinical characteristics of the affected patients.MethodsWe extracted data regarding 1099 patients with laboratory-confirmed Covid-19 from 552 hospitals in 30 provinces, autonomous regions, and municipalities in mainland China through January 29, 2020. The primary composite end point was admission to an intensive care unit (ICU), the use of mechanical ventilation, or death.ResultsThe median age of the patients was 47 years; 41.9% of the patients were female. The primary composite end point occurred in 67 patients (6.1%), including 5.0% who were admitted to the ICU, 2.3% who underwent invasive mechanical ventilation, and 1.4% who died. Only 1.9% of the patients had a history of direct contact with wildlife. Among nonresidents of Wuhan, 72.3% had contact with residents of Wuhan, including 31.3% who had visited the city. The most common symptoms were fever (43.8% on admission and 88.7% during hospitalization) and cough (67.8%). Diarrhea was uncommon (3.8%). The median incubation period was 4 days (interquartile range, 2 to 7). On admission, ground-glass opacity was the most common radiologic finding on chest computed tomography (CT) (56.4%). No radiographic or CT abnormality was found in 157 of 877 patients (17.9%) with nonsevere disease and in 5 of 173 patients (2.9%) with severe disease. Lymphocytopenia was present in 83.2% of the patients on admission.ConclusionsDuring the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings. (Funded by the National Health Commission of China and others.)

Analysis of the first cluster of cases in a family of novel coronavirus pneumonia in Gansu Province

The epidemiological history and clinical characteristics of 7 cases of COVID-19 and 1 case of close contact in the first family aggregation epidemic of COVID-19 in Gansu Province were analyzed. The first patient A developed on January 22, 2020, with a history of residence in Wuhan, and confirmed severe cases of NCP on January 24, 2020; patient B, on January 23, 2020, diagnosed on January 31, severe cases; patient C, asymptomatic, diagnosed on January 27; patient D, asymptomatic, diagnosed on January 27; patient E, on January 24, diagnosed on January 28; patient F, asymptomatic, diagnosed on January 31; Patient G was asymptomatic and was diagnosed on January 31. In close contact, H was asymptomatic, PCR test was negative and asymptomatic, and he was discharged early. Among the 7 patients, 1 case died of (B) aggravation, and the other patients' condition was effectively controlled after active treatment. Except for the discharged cases, 5 cases were positive for COVID-19 specific IgM antibody and 1 case was negative. In this clustering outbreak, 4 patients remained asymptomatic, but PCR and IgM antibodies were positive, indicating that asymptomatic patients may be the key point to control the epidemic. Specific IgM antibody screening for patients whose pharyngeal swab nucleic acid test is negative but with ground glass-like lung lesions is very important for early detection and early isolation.