From SARS to COVID-19: What lessons have we learned?

Pseudorabies Virus Glycoproteins E and B Application in Vaccine and Diagnosis Kit Development

Background: Pseudorabies virus (PRV) is a highly infectious pathogen that affects a wide range of mammals and imposes a significant economic burden on the global pig industry. The viral envelope of PRV contains several glycoproteins, including glycoprotein E (gE) and glycoprotein B (gB), which play critical roles in immune recognition, vaccine development, and diagnostic procedures. Mutations in these glycoproteins may enhance virulence, highlighting the need for updated vaccines. Method: This review examines the functions of PRV gE and gB in vaccine development and diagnostics, focusing on their roles in viral replication, immune system interaction, and pathogenicity. Additionally, we explore recent findings on the importance of gE deletion in attenuated vaccines and the potential of gB to induce immunity. Results: Glycoprotein E (gE) is crucial for the virus's axonal transport and nerve invasion, facilitating transmission to the central nervous system. Deletion of gE is a successful strategy in vaccine development, enhancing the immune response. Glycoprotein B (gB) plays a central role in viral replication and membrane fusion, aiding viral spread. Mutations in these glycoproteins may increase PRV virulence, complicating vaccine efficacy. Conclusion: With PRV glycoproteins being essential to both vaccine development and diagnostic approaches, future research should focus on enhancing these components to address emerging PRV variants. Updated vaccines and diagnostic tools are critical for combating new, more virulent strains of PRV.

High Prevalence of Borrelia burgdorferi Antibodies in Jaworzno, Poland: A Retrospective Study Revealing Endemic Lyme Borreliosis

BACKGROUND This retrospective study of 704 adult residents of Jaworzno, Poland, aimed to evaluate medical personnel awareness of episodes of Lyme borreliosis and serum antibody levels for Borrelia burgdorferi sensu lato. MATERIAL AND METHODS This study included 704 residents of Jaworzno, Poland, who had no more than 12 months between tick bite and screening. The study consisted of a self-designed questionnaire survey and an analysis of IgG and IgM antibodies against B. burgdorferi sensu lato using an enzyme-linked assay (ELISA) and Western blot analysis, when necessary, to confirm the results. RESULTS A total of 558 residents (79.3%) confirmed having contact with a tick, 84 (11.9%) responded that they did not remember having contact with a tick, and 62 (8.8%) denied having contact with a tick. Regarding IgG, the ELISA showed 183 (25.99%) positive, 440 (62.5%) negative, and 81 (11.5%) equivocal results. Regarding IgM, the ELISA showed 180 (25.57%) positive, 435 (61.79%) negative, and 89 (12.64%) equivocal results. Positive and equivocal results for the IgG and IgM classes using the ELISA test were confirmed in 36 cases (13.64%) for IgG and in 53 cases (19.70%) for IgM using Western blot analysis. CONCLUSIONS The ELISA method obtained similar values for positive, negative, and equivocal results in the serological test. This was reflected in the survey conducted on residents who reported a tick bite and later received a positive result in the ELISA test as well as an approximate time between the bite and removal of the tick.

Quantifying Health Policy Uncertainty in China Using Newspapers: Text Mining Study

BACKGROUND

From the severe acute respiratory syndrome (SARS) outbreak in 2003 to the COVID-19 pandemic in 2019, a series of health measures and policies have been introduced from the central to the local level in China. However, no study has constructed an uncertainty index that can reflect the volatility, risk, and policy characteristics of the health environment.

OBJECTIVE

We used text mining analysis on mainstream newspapers to quantify the volume of reports about health policy and the total number of news articles and to construct a series of indexes that could reflect the uncertainty of health policy in China.

METHODS

Using the Wisenews database, 11 of the most influential newspapers in mainland China were selected to obtain the sample articles. The health policy uncertainty (HPU) index for each month from 2003 to 2022 was constructed by searching articles containing the specified keywords and calculating their frequency. Robustness tests were conducted through correlation analysis. The HPU index was plotted using STATA (version 16.0), and a comparative analysis of the China and US HPU indexes was then performed.

RESULTS

We retrieved 6482 sample articles from 7.49 million news articles in 11 newspapers. The China HPU index was constructed, and the robustness test showed a correlation coefficient greater than 0.74, which indicates good robustness. Key health events can cause index fluctuations. At the beginning of COVID-19 (May 2020), the HPU index climbed to 502.0. In December 2022, China's HPU index reached its highest value of 613.8 after the release of the "New Ten Rules" pandemic prevention and control policy. There were significant differences in HPU index fluctuations between China and the United States during SARS and COVID-19, as well as during the Affordable Care Act period.

CONCLUSIONS

National health policy is a guide for health development, and uncertainty in health policy can affect not only the implementation of policy by managers but also the health-seeking behavior of the people. Here, we conclude that changes in critical health policies, major national or international events, and infectious diseases with widespread impact can create significant uncertainty in China's health policies. The uncertainty of health policies in China and the United States is quite different due to different political systems and news environments. What is the same is that COVID-19 has brought great policy volatility to both countries. To the best of our knowledge, our work is the first systematic text mining study of HPU in China.

Porcine epidemic diarrhea virus: an update overview of virus epidemiology, vaccines, and control strategies in South Korea

Porcine epidemic diarrhea virus (PEDV) has posed significant financial threats to the domestic pig industry over the last three decades in South Korea. PEDV infection will mostly result in endemic persistence in the affected farrow-to-finish (FTF) herds, leading to endemic porcine epidemic diarrhea (PED) followed by year-round recurrent outbreaks. This review aims to encourage collaboration among swine producers, veterinarians, and researchers to offer answers that strengthen our understanding of PEDV in efforts to prevent and control endemic PED and to prepare for the next epidemics or pandemics. We found that collaboratively implementing a PED risk assessment and customized four-pillar-based control measures is vital to interrupt the chain of endemic PED in affected herds: the former can identify on-farm risk factors while the latter aims to compensate for or improve weaknesses via herd immunity stabilization and virus elimination. Under endemic PED, long-term virus survival in slurry and asymptomatically infected gilts ("Trojan Pigs") that can transmit the virus to farrowing houses are key challenges for PEDV eradication in FTF farms and highlight the necessity for active monitoring and surveillance of the virus in herds and their environments. This paper underlines the current knowledge of molecular epidemiology and commercially available vaccines, as well as the risk assessment and customized strategies to control PEDV. The intervention measures for stabilizing herd immunity and eliminating virus circulation may be the cornerstone of establishing regional or national PED eradication programs.

Temporal association between the age-specific incidence of Guillain-Barré syndrome and SARS-CoV-2 vaccination in Republic of Korea: a nationwide time-series correlation study

BACKGROUND

The incidence of Guillain-Barré syndrome (GBS) changed significantly during the coronavirus disease 2019 (COVID-19) pandemic. Emerging reports suggest that viral vector-based vaccines may be associated with an elevated risk of GBS.

METHODS

In this nationwide time-series correlation study, we examined the age-specific incidence of GBS from January 2011 to August 2022, as well as data on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccinations and infections from February 2021 to August 2022. We compared the forecasted estimates of age-specific GBS incidence, using the pre-SARS-CoV-2 period as a benchmark, with the actual incidence observed during the post-vaccination period of the pandemic. Furthermore, we assessed the temporal association between GBS, SARS-CoV-2 vaccinations, and COVID-19 for different age groups.

RESULTS

In the age group of 60 and older, the rate ratio was significantly elevated during June-August and November 2021. A significant, strong positive association was observed between viral vector-based vaccines and GBS incidence trends in this age group (r=0.52, p=0.022). For the 30 to 59 years age group, the rate ratio was notably high in September 2021. A statistically significant, strong positive association was found between mRNA-based vaccines and GBS incidence in this age group (r=0.61, p=0.006).

CONCLUSION

Viral vector-based SARS-CoV-2 vaccines were found to be temporally associated with an increased risk of GBS, particularly in older adults. To minimize age-specific and biological mechanism-specific adverse events, future vaccination campaigns should adopt a more personalized approach, such as recommending homologous mRNA-based SARS-CoV-2 vaccines for older adults to reduce the heightened risk of GBS.

Exploring the Associations between Happiness, Life-satisfaction, Anxiety, and Emotional Regulation among Adults during the Early Stage of the COVID-19 Pandemic in Russia

Background

The COVID-19 pandemic is not only a world health crisis, but also an ordeal for people's mental health and psychological well-being. The period of the COVID-19 lockdown has changed everyday life and increased anxiety, fears, and stress from habitual activities such as meetings, shopping, and the use of public transport. As the worry and nervousness increase, they threaten the cognitive (Life-satisfaction) and emotional (Happiness) components of well-being. Emotional regulation strategies are a mechanism to cope with the threat.

Objective

This study assessed the impact of anxiety, perceived stress from COVID-19, and emotional regulation strategies on well-being during the first weeks of the lockdown in Russia.

Design

Questionnaire-based surveys were conducted online from March 31 to April 30, 2020. A total of 589 participants (18 to 73 years of age) were recruited. The Subjective Happiness Scale, Satisfaction with Life Scale, Zung's Self-Rating Anxiety Scale, Emotion Regulation Questionnaire, and Perceived Source of Stress from COVID-19 scales were used.

Results

Among the various sources of stress, only that from restrictions on everyday life impacted well-being. High anxiety, but not perceived stress, decreased the feelings of Happiness and Life-satisfaction. Additionally, emotional regulation strategies played different roles in their impact on well-being: Cognitive reappraisal lowered negative emotions, but emotional suppression increased dissatisfaction with life.

Conclusion

These findings suggest that people's effective and relevant regulation of their emotions during public health emergencies and ability to avoid losses caused by crisis events, have become urgent needs, requiring the development of psychological interventions to support well-being.

Perceptions of the SARS-CoV2 pandemic: a small comparative survey analysis between language preference populations in a United States community health center

In 2019, a new variant of coronavirus, SARS-CoV-2 (COVID-19) created a global pandemic that has highlighted and exacerbated health disparities. Educating the general public about COVID-19 is one of the primary mitigation strategies amongst health professionals. English is not the preferred language for an estimated 22% of the United States population making effective mass communication efforts difficult to achieve. This study seeks to understand and compare several topics surrounding COVID-19 health communication and healthcare disparities between individuals with English language preference (ELP) and non-English language preference (NELP) within the United States. A survey available in seven languages asking about knowledge and opinions on COVID-19, vaccines, preferred sources of health information, and other questions, was administered February-April 2021 to patients at an urban federally qualified health center that also serves global refugees and immigrants. Descriptive statistics and comparative analysis were performed to identify differences between ELP and NELP individuals. Analysis of 144 surveys, 33 of which were NELP, showed 90.97% of all patients agreed that COVID-19 was a serious disease and 66.67% would receive the COVID-19 vaccine. There were numerous differences between ELP and NELP individuals, including trust in government, symptom identification, preferred source of health information, and feelings that cultural needs had been met. This study has identified several significant differences in patient perceptions relating to the COVID-19 pandemic when comparing NELP to ELP and highlighted areas where improvement can occur. Applying this information, easily utilized targeted resources can be created to quickly intervene and address health disparities among patients seeking care at an urban community health center.

The long-term dynamic relationship between communicable disease spread, economic prosperity, greenhouse gas emissions, and government health expenditures: preparing for COVID-19-like pandemics

The spread of communicable diseases, such as COVID-19, has a detrimental effect on our socio-economic structure. In a dynamic log-run world, socio-economic and environmental factors interact to spread communicable diseases. We investigated the long-term interdependence of communicable disease spread, economic prosperity, greenhouse gas emissions, and government health expenditures in India's densely populated economy using a variance error correction (VEC) approach. The VEC model was validated using stationarity, cointegration, autocorrelation, heteroscedasticity, and normality tests. Our impulse response and variance decomposition analyses revealed that economic prosperity (GNI) significantly impacts the spread of communicable diseases, greenhouse gas emissions, government health expenditures, and GNI. Current health expenditures can reduce the need for future increases, and the spread of communicable diseases is detrimental to economic growth. Developing economies should prioritize economic growth and health spending to combat pandemics. Simultaneously, the adverse effects of economic prosperity on environmental degradation should be mitigated through policy incentives.

From SARS to COVID-19: the role of experience and experts in Hong Kong's initial policy response to an emerging pandemic

As one of the most densely populated places in the world, Hong Kong fared relatively well in the first year of the COVID-19 pandemic, with a very low number of cases and fatalities per capita. This was mostly due to the Hong Kong government, healthcare workers, and the general public's institutional and individual memory after they successfully overcame the deadly severe acute respiratory syndrome (SARS) epidemic in 2003. However, while Hong Kong was well accustomed to measures such as wearing masks and social distancing, the cooperation of the Hong Kong public to government restrictions was highly affected by its local political context, especially after widespread anti-government protests began mid-2019. This brought the public's trust in government to an all-time low, creating a political 'new normal', which underpinned how COVID-19 policies would be proposed, accepted, and implemented, if at all. To understand how science advice was offered and how public health decisions were made, this research investigates the evolution of Hong Kong's science advisory mechanisms for public health from before SARS, after SARS, and during COVID-19 in 2020, including the roles of key organisations and departments, the establishment of new centres and committees, and the creation of workgroups and expert advisory panels. This paper compares and analyses the reasons behind these differences in science advisory mechanisms between SARS and COVID-19. The findings from this research reinforce the unquestionable need for robust science advisory structures and knowledgeable scientific experts to solve health-related crises, though more research is required to understand the ways in which science advice influences both policy decisions and public acceptance of these policies.

Multinational primary health care experiences from the initial wave of the COVID-19 pandemic: A qualitative analysis

OBJECTIVE

To learn from primary health care experts' experiences from the COVID-19 pandemic across countries.

METHODS

We applied qualitative thematic analysis to open-text responses from a multinational rapid response survey of primary health care experts assessing response to the initial wave of the COVID-19 pandemic.

RESULTS

Respondents' comments focused on three main areas of primary health care response directly influenced by the pandemic: 1) impact on the primary care workforce, including task-shifting responsibilities outside clinician specialty and changes in scope of work, financial strains on practices, and the daily uncertainties and stress of a constantly evolving situation; 2) impact on patient care delivery, both essential care for COVID-19 cases and the non-essential care that was neglected or postponed; 3) and the shift to using new technologies.

CONCLUSIONS

Primary health care experiences with the COVID-19 pandemic across the globe were similar in their levels of workforce stress, rapid technologic adaptation, and need to pivot delivery strategies, often at the expense of routine care.

A comparison between SARS-CoV-1 and SARS-CoV2: an update on current COVID-19 vaccines

Since the outbreak of the novel coronavirus disease 2019 (COVID-19) in Wuhan, China, many health care systems have been heavily engaged in treating and preventing the disease, and the year 2020 may be called as "historic COVID-19 vaccine breakthrough". Due to the COVID-19 pandemic, many companies have initiated investigations on developing an efficient and safe vaccine against the virus. From Moderna and Pfizer in the United States to PastocoVac in Pasteur Institute of Iran and the University of Oxford in the United Kingdom, different candidates have been introduced to the market. COVID-19 vaccine research has been facilitated based on genome and structural information, bioinformatics predictions, epitope mapping, and data obtained from the previous developments of severe acute respiratory syndrome coronavirus (SARS-CoV or SARS-CoV-1) and middle east respiratory syndrome coronavirus (MERS-CoV) vaccine candidates. SARS-CoV genome sequence is highly homologous to the one in COVID-19 and both viruses use the same receptor, angiotensin-converting enzyme 2 (ACE2). Moreover, the immune system responds to these viruses, partially in the same way. Considering the on-going COVID-19 pandemic and previous attempts to manufacture SARS-CoV vaccines, this paper is going to discuss clinical cases as well as vaccine challenges, including those related to infrastructures, transportation, possible adverse reactions, utilized delivery systems (e.g., nanotechnology and electroporation) and probable vaccine-induced mutations.

Metal organic framework encapsulated tamavidin-Gluc reporter: application in COVID-19 spike antigen bioluminescent immunoassay

Enzyme linked immunosorbent assay (ELISA) is one of the most utilized serological methods to diagnose and identify etiologic agents of many infectious diseases and other physiologically important analytes. ELISA can be used either alone or adjunct to other diagnostic methods such as molecular arrays, and other serological techniques. Most ELISA assays utilize reagents that are proteinaceous in nature, which are not very stable and require cold-chain transport systems. Development of a desirable immunoassay requires stability of reagents used and its ability to be stored at room temperature without sacrificing the activity of the reagents or the protein of interest. Metal organic frameworks (MOFs) are a rapidly emerging and evolving class of porous polymeric materials used in a variety of biosensor applications. In this study, we introduce the use of MOFs to stabilize a universal reporter fusion protein, specifically, avidin-like protein (Tam-avidin2) and the small bioluminescent protein Gaussia luciferase (Gluc) forming the fusion reporter, tamavidin2-Gluc (TA2-Gluc). This fusion protein serves as a universal reporter for any assays that utilize biotin-avidin binding strategy. Using SARS-CoV2 S1 spike antigen as the model target antigen, we demonstrated that encapsulation of TA2-Gluc fusion protein using a nano-porous material, zeolitic imidazolate framework-8 (ZIF-8), allows us to store and preserve this reporter protein at room temperature for over 6 months and use it as a reporter for an ELISA assay. Our optimized assay was validated demonstrating a 0.26 μg mL-1 limit of detection, high reproducibility of assay over days, detection of spiked non-virulent SARS-COV2 pseudovirus in real sample matrix, and detection in real COVID-19 infected individuals. This result can lead to the utilization of our TA2-Gluc fusion protein reporter with other assays and potentially in diagnostic technologies in a point-of-care setting.

Effect of prior outbreak work experience to future outbreak responses for nurses in Hong Kong: A cross-sectional study

Background

During the early phase of the Coronavirus Disease 2019 (COVID-19) epidemic, health care workers had elevated levels of psychological distress. Historical exposure to disease outbreak may shape different pandemic responses among experienced health care workers.

Aim

Considering the unique experience of the 2003 SARS outbreak in Hong Kong, this study examined the association between prior epidemic work experience and anxiety levels, and the mediating role of perceived severity of COVID-19 and SARS in nurses.

Methods

In March 2020, a cross-sectional survey targeting practising nurses in Hong Kong was conducted during the early phase of the COVID-19 epidemic. The interrelationships among participants' work experience during the SARS outbreak, perceived severity of SARS and COVID-19, and anxiety level were elucidated using structural equation model (SEM).

Findings

Of 1,061 eligible nurses, a majority were female (90%) with a median age of 39 years (IQR = 32-49). A significant and negative indirect association was identified between SARS experience and anxiety levels (B=-0.04, p=0.04) in the SEM with a satisfactory fitness (CFI=0.95; RMSEA=0.06). SARS-experienced nurses perceived SARS to be less severe (B=-0.17, p=0.01), translated an equivalent perception to COVID-19 (B=1.29, p<0.001) and resulted in a lower level of anxiety (B=0.19, p<0.001).

Conclusions

The less vigorous perception towards the severity of SARS and COVID-19 may explain SARS-experienced nurses' less initial epidemic-induced anxiety. The possible role of outbreak-experienced nurses in supporting outbreak-inexperienced nurses, both emotionally and technically, should be considered when an epidemic commences. Interventions aiming to facilitate the understanding of emerging virus should also be in place.

Moving toward a common goal via cross-sector collaboration: lessons learned from SARS to COVID-19 in Singapore

Background

The spread of COVID-19 has taken a toll on many countries and its healthcare system over the last two years. Governments have sought to mitigate the repercussions of the pandemic by implementing aggressive top-down control measures and introducing immense fiscal spending. Singapore is no exception to this trend. Owing to a whole-of-society approach, Singapore is still being lauded globally for its relatively successful record at controlling both community and trans-border spread. One notable effort by the Singapore government has taken place through its cross-sectoral collaborative partnerships with the private stakeholders behind the success.

Methods/results

In an attempt to better explain Singapore’s robust yet strategic response to COVID-19, this study focuses on how the experience of the SARS outbreak has informed the government’s collaborative efforts with other stakeholders in society, beyond mere transnational cooperation. Taking a comparative case study approach in the specific context of Singapore, we perform a content analysis of related government documents, mainstream newspaper articles, and academic journal articles in an inductive manner. By closely comparing two global healthcare outbreaks, we note four differences in approach. First, during the COVID-19 pandemic, Singapore has focused on securing sufficient essential healthcare resources with contingency plans to strengthen preparedness. Second, the government has actively harnessed the capacity of private entities to promote the resilience of the healthcare system and the community. Third, Singapore’s management policies have been made not only in a top-down, centralized style during the initial response stage, but also with a greater proportion of bottom-up approaches, particularly as the pandemic trudges on. More interestingly, the multi-faceted repercussions of COVID-19 have gradually opened the door to a greater variety of collaborative partnerships in sectors beyond healthcare services. The participating stakeholders include, but are not limited to, local and international business actors, non-profit organizations, academia and other countries. Lastly, as the pandemic has continued, the Singapore government has managed outward to tap the expertise and knowledge of the private sector, in particular leveraging science and technology to improve control measures and putting supportive programs into practice.

Conclusion

The evidence from our focused analyses demonstrates that the nature and scale of the COVID-19 pandemic produced more collaborative partnerships between the public and private sectors in Singapore as compared with the SARS outbreak. What is more, our findings offer evidence that through adaptive learning from the prior global healthcare outbreak, plus some trial and error during the initial phase of the ongoing pandemic, public- and private-sector partners, both in and outside of the healthcare service sector, have tended to “act alike,” working together to achieve a common goal. Both have been socially responsible, providing public services to people in need to promote the rapid resilience of the community, and sharing the associated risks. Overall, this study has deep and wide implications for other governments and policy makers who are still struggling to maximize essential resources and minimize the negative impacts of the healthcare crisis.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12992-022-00873-x.

Investigation of Statistical Machine Learning Models for COVID-19 Epidemic Process Simulation: Random Forest, K-Nearest Neighbors, Gradient Boosting

COVID-19 has become the largest pandemic in recent history to sweep the world. This study is devoted to developing and investigating three models of the COVID-19 epidemic process based on statistical machine learning and the evaluation of the results of their forecasting. The models developed are based on Random Forest, K-Nearest Neighbors, and Gradient Boosting methods. The models were studied for the adequacy and accuracy of predictive incidence for 3, 7, 10, 14, 21, and 30 days. The study used data on new cases of COVID-19 in Germany, Japan, South Korea, and Ukraine. These countries are selected because they have different dynamics of the COVID-19 epidemic process, and their governments have applied various control measures to contain the pandemic. The simulation results showed sufficient accuracy for practical use in the K-Nearest Neighbors and Gradient Boosting models. Public health agencies can use the models and their predictions to address various pandemic containment challenges. Such challenges are investigated depending on the duration of the constructed forecast.

Loss of life expectancy due to respiratory infectious diseases: findings from the global burden of disease study in 195 countries and territories 1990-2017

Understanding of the patterns of and changes in mortality from respiratory infectious diseases (RID) and its contribution to loss of life expectancy (LE) is inadequate in the existing literature. With rapid sociodemographic changes globally, and the current COVID-19 pandemic, it is timely to revisit the disease burden of RID. Using the approaches of life table and cause-eliminated life table based on data from the Global Burden of Disease Study (GBD), the study analyses loss of LE due to RID in 195 countries/territories and its changes during the period 1990-2017. Results indicate that loss of LE due to RID stood at 1.29 years globally in 2017 globally and varied widely by age, gender, and geographic location, with men, elderly people, and populations in middle/low income countries/territories suffering a disproportionately high loss of LE due to RID. Additionally, loss of LE due to RID decreased remarkably by 0.97 years globally during the period 1990-2017 but increased slightly among populations older than 70 years and in many high income countries/territories. Results suggest that RID still pose a severe threat for population and public health, and that amid dramatic sociodemographic changes globally, the disease burden of RID may resurge. The study presents the first examination of the life-shortening effect of RID at the global and country/territory levels, providing new understanding of the changing disease burden of RID and shedding light on the potential consequences of the current COVID-19 pandemic.

Predictive Machine Learning Models and Survival Analysis for COVID-19 Prognosis Based on Hematochemical Parameters

The coronavirus disease 2019 (COVID-19) pandemic has affected hundreds of millions of individuals and caused millions of deaths worldwide. Predicting the clinical course of the disease is of pivotal importance to manage patients. Several studies have found hematochemical alterations in COVID-19 patients, such as inflammatory markers. We retrospectively analyzed the anamnestic data and laboratory parameters of 303 patients diagnosed with COVID-19 who were admitted to the Polyclinic Hospital of Bari during the first phase of the COVID-19 global pandemic. After the pre-processing phase, we performed a survival analysis with Kaplan–Meier curves and Cox Regression, with the aim to discover the most unfavorable predictors. The target outcomes were mortality or admission to the intensive care unit (ICU). Different machine learning models were also compared to realize a robust classifier relying on a low number of strongly significant factors to estimate the risk of death or admission to ICU. From the survival analysis, it emerged that the most significant laboratory parameters for both outcomes was C-reactive protein min; HR=17.963 (95% CI 6.548–49.277, p < 0.001) for death, HR=1.789 (95% CI 1.000–3.200, p = 0.050) for admission to ICU. The second most important parameter was Erythrocytes max; HR=1.765 (95% CI 1.141–2.729, p < 0.05) for death, HR=1.481 (95% CI 0.895–2.452, p = 0.127) for admission to ICU. The best model for predicting the risk of death was the decision tree, which resulted in ROC-AUC of 89.66%, whereas the best model for predicting the admission to ICU was support vector machine, which had ROC-AUC of 95.07%. The hematochemical predictors identified in this study can be utilized as a strong prognostic signature to characterize the severity of the disease in COVID-19 patients.

Mobile Apps Leveraged in the COVID-19 Pandemic in East and South-East Asia: Review and Content Analysis

Background

The COVID-19 pandemic increased attention to digital tools to support governmental public health policies in East and South-East Asia. Mobile apps related to the COVID-19 pandemic continue to emerge and evolve with a wide variety of characteristics and functions. However, there is a paucity of studies evaluating such apps in this region, with most of the available studies conducted in the early days of the pandemic.

Objective

This study aimed to examine free apps developed or supported by governments in the East and South-East Asian region and highlight their key characteristics and functions. We also sought to interpret how the release dates of these apps were related to the commencement dates of other COVID-19 public health policies.

Methods

We systematically searched for apps in Apple App Store and Google Play Store and analyzed the contents of eligible apps. Mobile apps released or updated with COVID-19–related functions between March 1 and May 7, 2021, in Singapore, Taiwan, South Korea, China (mainland), Japan, Thailand, Hong Kong, Vietnam, Malaysia, Indonesia, and the Philippines were included. The CoronaNet Research Project database was also examined to determine the timeline of public health policy commencement dates in relation to the release dates of the included apps. We assessed each app’s official website, media reports, and literature through content analysis. Descriptive statistics were used to summarize relevant information gathered from the mobile apps using RStudio.

Results

Of the 1943 mobile apps initially identified, 46 were eligible, with almost 70% of the apps being intended for the general public. Most apps were from Vietnam (n=9, 20%), followed by Malaysia, Singapore, and Thailand (n=6 each, 13%). Of note, most apps for quarantine monitoring (n=6, 13%) were mandatory for the target users or a population subset. The most common function was health monitoring (32/46, 70%), followed by raising public health awareness (19/46, 41%) through education and information dissemination. Other functions included monitoring quarantine (12/46, 26%), providing health resources (12/46, 26%). COVID-19 vaccination management functions began to appear in parallel with vaccine rollout (7/46, 15%). Regarding the timing of the introduction of mobile solutions, the majority of mobile apps emerged close to the commencement dates of other public health policies in the early stages of the pandemic between March and April 2020.

Conclusions

In East and South-East Asia, most governments used mobile health apps as adjuncts to public health measures for tracking COVID-19 cases and delivering credible information. In addition, these apps have evolved by expanding their functions for COVID-19 vaccination.

The Influence of Family Function on State Anxiety of Chinese College Students During the Epidemic of COVID-19

The Coronavirus Disease 2019 (COVID-19) may affect mental health. There is little research about the influence of family function on the state anxiety of college students in the context of the global pandemic. The study aimed to clarify that generalized anxiety disorder (GAD) and trait anxiety had mediating effects in family function on the state anxiety of Chinese college students following the "stay-at-home" order during the outbreak of COVID-19. This cross-sectional study was conducted online with 1,039 respondents. We analyzed demographics, The State-Trait Anxiety Inventory (ST-AI) and Chinese Family Function Scale (FAD-18), Generalized Anxiety Disorder-7 (GAD-7), and used path analysis to discuss the influence of family function on state and trait anxiety. The results showed that female students' state and trait anxiety was higher than that of male students (P < 0.05). Medical students' state and trait anxiety was lower than that of literature students (P < 0.05). The GAD of the male was lower compared with the female. The score of family function has significant differences in gender, age, education, and region (P < 0.05). Gender, family function, state anxiety, trait anxiety, and GAD relate to others (r = 0.07∼0.85, p < 0.05). The results of fit indices for measurement invariance models showed that the impact of family function among GAD, state and trait anxiety across gender is significantly different (each step p < 0.05). GAD and trait anxiety had a complete meditating effect between family function and state anxiety (the proportion of standard indirect mediating effect was 24.94% in females and 36.79% in males). A healthy family function may alleviate GAD and anxiety of college students during the COVID-19 pandemic.

Homologous and heterologous serological response to the N-terminal domain of SARS-CoV-2 in humans and mice

The increasing numbers of infected cases of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) poses serious threats to public health and the global economy. Most SARS-CoV-2 neutralizing antibodies target the receptor binding domain (RBD) and some the N-terminal domain (NTD) of the spike protein, which is the major antigen of SARS-CoV-2. While the antibody response to RBD has been extensively characterized, the antigenicity and immunogenicity of the NTD protein are less well studied. Using 227 plasma samples from COVID-19 patients, we showed that SARS-CoV-2 NTD-specific antibodies could be induced during infection. As compared to the results of SARS-CoV-2 RBD, the serological response of SARS-CoV-2 NTD is less cross-reactive with SARS-CoV, a pandemic strain that was identified in 2003. Furthermore, neutralizing antibodies are rarely elicited in a mice model when NTD is used as an immunogen. We subsequently demonstrate that NTD has an altered antigenicity when expressed alone. Overall, our results suggest that while NTD offers a supplementary strategy for serology testing, it may not be suitable as an immunogen for vaccine development.

Occupational Commitment of Chinese Kindergarten Teachers During the COVID-19 Pandemic: Predictions of Anti-Epidemic Action, Income Reduction, and Career Confidence

This study highlights a survey on 5783 kindergarten teachers' occupational commitment and its influencing factors in the socioeconomic context of China during the COVID-19 pandemic. Data were collected through the WenJuanXing public online platform. Quantitative analysis results showed that kindergarten teachers' occupational commitment was optimistic on the whole during this period, among which the affective commitment and the normative commitment were satisfactory, but the continuing commitment needed to be strengthened. The type of kindergartens, the personnel affiliation, the educational background, and the professional post of kindergarten teachers had significant impacts on their occupational commitment. The income reduction was negatively correlated with and predictive of kindergarten teachers' occupational commitment. Anti-epidemic action and career confidence were positively correlated with and predictive of kindergarten teachers' occupational commitment. Furthermore, anti-epidemic action, income reduction, and career confidence had joint predictive effects on kindergarten teachers' occupational commitment. More related backgrounds and suggestions have been discussed.

The Role of Indoor Plants in air Purification and Human Health in the Context of COVID-19 Pandemic: A Proposal for a Novel Line of Inquiry

The last two decades have seen the discovery of novel retroviruses that have resulted in severe negative consequences for human health. In late 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged with a high transmission rate and severe effects on human health, with 5% infected persons requiring hospitalisation and 3.81 million deaths to date globally. Aerosol particles containing virions are considered the main source of SARS CoV-2 transmission in this pandemic, with increased infection rates in confined spaces. Consequently, public and private institutions had to institute mitigation measures including the use of facial masks and social distancing to limit the spread of the virus. Moreover, the role of air purification and bio-decontamination is understood as being essential to mitigate viral spread. Various techniques can be applied to bio-decontaminate the air such as the use of filtration and radiation; however, these methods are expensive and not feasible for home use. Another method of air purification is where indoor plants can purify the air by the removal of air pollutants and habituated airborne microbes. The use of indoor plants could prove to be a cost-efficient way of indoor air-purification that could be adapted for a variety of environments with no need for special requirements and can also add an aesthetic value that can have an indirect impact on human health. In this review, we discuss the emergence of the COVID-19 pandemic and the currently used air purification methods, and we propose the use of indoor plants as a new possible eco-friendly tool for indoor air purification and for reducing the spread of COVID-19 in confined places.

The psychological symptoms of patients with mild symptoms of coronavirus disease (2019) in China: A cross-sectional study

AIMS

To determine psychological symptoms of patients with mild symptoms of coronavirus disease 2019 in China and to explore the influencing factors.

DESIGN

A cross-sectional study.

METHODS

A convenience sample of 296 mild coronavirus disease 2019 patients were recruited from a Fangcang hospital in Wuhan, Hubei Province, from 3-5 March, 2020. Participants were assessed using a sociodemographic and clinical characteristics questionnaire, and Symptom Check List 90. The binary logistic regression was utilized to explore the influencing factors of psychological symptoms of patients with mild symptoms of coronavirus disease 2019.

RESULTS

In total, 296 of 299 patients with mild symptoms of coronavirus disease 2019 participated in the study (response rate: 99.0%). The findings revealed that 12.8% patients with mild symptoms have mental health problems; the most common psychological symptoms are phobic anxiety (58.4%), paranoid ideation (50.7%) and psychoticism (40.2%). Female patients [OR = 3.587, 95% CI (1.694-7.598)] and those having physical symptoms currently [OR = 2.813, 95% CI (1.210-6.539)] are at higher risk, while those in the middle duration of hospitalization [OR = 0.278, 95% CI (0.121-0.639)] protect against mental-health problems.

CONCLUSIONS

The minority of patients with mild symptoms of coronavirus disease 2019 were still suffering from psychological symptoms. Healthcare providers are recommended to pay particular attention to screening these high-risk groups (women, those in the initial stages of hospitalization and those with physical symptoms currently) and implement targeted psychological care as required.

IMPACT

This study found that most patients of coronavirus disease 2019 in Fangcang hospital exhibited normal mental health at par with the general Chinese norm and the minority of them were suffering from psychological symptoms. The findings can provide a reference for healthcare providers to screen high-risk psychological symptoms groups and implement targeted psychological intervention for patients with coronavirus disease 2019.

Iran COVID-19 Epidemiology Committee: A Review of Missions, Structures, Achievements, and Challenges

Background: Since the beginning of the coronavirus disease 2019 (COVID-19) epidemic in Iran, the control and management of the epidemic were headed by the National Headquarter for the Control of COVID-19 Epidemic through setting up different scientific committees, including the COVID-19 National Epidemiology Committee. The present study reviews the missions, structures, achievements, and challenges of the Epidemiology Committee.

Study design: A rapid review

Methods: All relevant reports, documents, guidelines, published literature, and surveillance data related to the establishment, visions, missions, roles, activities, and outputs of the COVID-19 Epidemiology Committee were critically reviewed in this study.

Results: The efforts of the committee’s working groups may have impacted improvements in data registration/usage, provincial data quality at provincial levels, and perception of the epidemic situation in the provinces. The committees have also played role in informing the policies in different stages of the epidemic through routine or problem-based data/evidence analyses, epidemic investigations, and mathematical modeling.

Conclusions: The structure and experience gained by the committee can be used in similar situations within and outside the country. To further improve the impacts of our activities, it is essential to have effective interaction, collaboration, and data flow between the committee and a broad range of organizations within and outside the Ministry of Health and Medical Education.

Porcine enteric coronaviruses: an updated overview of the pathogenesis, prevalence, and diagnosis

The recent prevalence of coronavirus (CoV) poses a serious threat to animal and human health. Currently, porcine enteric coronaviruses (PECs), including the transmissible gastroenteritis virus (TGEV), the novel emerging swine acute diarrhoea syndrome coronavirus (SADS-CoV), porcine delta coronavirus (PDCoV), and re-emerging porcine epidemic diarrhoea virus (PEDV), which infect pigs of different ages, have caused more frequent occurrences of diarrhoea, vomiting, and dehydration with high morbidity and mortality in piglets. PECs have the potential for cross-species transmission and are causing huge economic losses in the pig industry in China and the world, which therefore needs to be urgently addressed. Accordingly, this article summarises the pathogenicity, prevalence, and diagnostic methods of PECs and provides an important reference for their improved diagnosis, prevention, and control.

Towards Covid-19 Literacy: Investigating the Literacy Levels of University Students in Colombia

Covid-19 literacy, induced by the coronavirus disease (2019), is characterized as the understanding of Covid-19 as well as informed decisions based upon this understanding. This type of literacy is closely related to health literacy, scientific literacy, and scientific media literacy. It may be obvious to say that Covid-19 literacy is a key factor for governments to effectively manage the Covid-19 transition. However, lack of literature exists about Covid-19 literacy among university students. Therefore, the current study aimed to determine the Covid-19 literacy level among 4168 students from a Colombian university. The data were derived from students' responses to a 25-item anonymous online self-reporting questionnaire. We found that 21-25-year age group, graduate students, students enrolled prior to 2015, and medical students had a significantly higher mean score. Moreover, the Internet (86.8%) was the most popular source of information from which participants gained most information regarding Covid-19. Furthermore, 58.5% of the participants considered health workers as a source that can provide accurate information. Most importantly, the findings reveal the students' knowledge about (1) the role of an eventual process of vaccination, (2) the test currently used as diagnostic for Covid-19, and (3) the fatality rate, three aspects of Covid-19 literacy that deserve more attention. The findings provide a useful basis for the formulation of policies and concrete actions in improving Covid-19 literacy.

Coping of Chinese Citizens Living in Spain during the COVID-19 Pandemic: Lessons for Personal Well-Being and Social Cohesion

Chinese citizens in China were the first affected by the COVID-19 outbreak. Nevertheless, the disease rapidly spread around the world, leading to the worst pandemic experienced in modern societies. Spain has become one of the countries more severely affected by it, while having a large Chinese community. This study aims to explore the perception of Chinese citizens living in Spain regarding the outbreak in their host country. Communicative interviews were conducted with ten Chinese men and women who had been living in Spain for at least five years. Results show cultural differences in the coping strategies of the Chinese as a response to the pandemic, which differ from those observed by the participants in their fellow Spanish citizens. These findings unveil the potential of integrating the cultural knowledge and coping strategies of migrant groups in the host communities in managing a pandemic, as well as the negative outcomes for social cohesion and well-being from new racism emerging in the context of COVID-19.

SARS-CoV-2/COVID-19 and advances in developing potential therapeutics and vaccines to counter this emerging pandemic

A novel coronavirus (SARS-CoV-2), causing an emerging coronavirus disease (COVID-19), first detected in Wuhan City, Hubei Province, China, which has taken a catastrophic turn with high toll rates in China and subsequently spreading across the globe. The rapid spread of this virus to more than 210 countries while affecting more than 25 million people and causing more than 843,000 human deaths, it has resulted in a pandemic situation in the world. The SARS-CoV-2 virus belongs to the genus Betacoronavirus, like MERS-CoV and SARS-CoV, all of which originated in bats. It is highly contagious, causing symptoms like fever, dyspnea, asthenia and pneumonia, thrombocytopenia, and the severely infected patients succumb to the disease. Coronaviruses (CoVs) among all known RNA viruses have the largest genomes ranging from 26 to 32 kb in length. Extensive research has been conducted to understand the molecular basis of the SARS-CoV-2 infection and evolution, develop effective therapeutics, antiviral drugs, and vaccines, and to design rapid and confirmatory viral diagnostics as well as adopt appropriate prevention and control strategies. To date, August 30, 2020, no effective, proven therapeutic antibodies or specific drugs, and vaccines have turned up. In this review article, we describe the underlying molecular organization and phylogenetic analysis of the coronaviruses, including the SARS-CoV-2, and recent advances in diagnosis and vaccine development in brief and focusing mainly on developing potential therapeutic options that can be explored to manage this pandemic virus infection, which would help in valid countering of COVID-19.