Age and Sex Differences Among Mildly Symptomatic and Asymptomatic Patients with Omicron Infection in 2022 in Shanghai, China

Effectiveness of the SARS-CoV-2 Vaccination in Preventing Severe Disease-Related Outcomes: A Population-Based Study in the Italian Province of Bolzano (South Tyrol)

Objective: To investigate the effectiveness of SARS-CoV2 vaccination in preventing ordinary or intensive care unit (ICU) admissions and deaths among cases registered during a variant transitional pandemic phase in the geographically and culturally unique territory of the Province of Bolzano (South Tyrol), an Italian region with low vaccination coverage. Methods: We collected data from 93,643 patients registered as positive for SARS-CoV-2 by health authorities during the winter of 2021-22. The data were analyzed retrospectively using descriptive statistics and multiple logistic regression. Results: 925 patients were hospitalized (0.99%), 89 (0.10%) were in intensive care, and 194 (0.21%) died. Vaccinated patients had a significantly lower risk of being hospitalized: adjusted Odds Ratio (aOR): 0.39; 95% CI: 0.33-0.46, ICU admission: aOR: 0.16; 95% CI: 0.09-0.29 and death: aOR: 0.41; 95% CI: 0.29-0.58. Similar risk reductions were also observed in booster-vaccinated patients, independent of sex, age, and predominant variant. Furthermore, the median length of stay (LoS) in the ICU was significantly longer for unvaccinated individuals compared to vaccinated subjects (9 vs. 6 days; p < 0.003). Conclusion: Primary series vaccination and ongoing campaign booster doses were effective in preventing all severe disease-related outcomes and in reducing ICU Length of Stay, even during a transitional pandemic phase and in a unique territorial context.

Primary healthcare workers' COVID-19 infection status following implementation of adjusted epidemic prevention and control strategies: a cross-sectional study in Jiangsu, China

Introduction

In times of epidemic outbreaks, healthcare workers (HCWs) emerge as a particularly vulnerable group. This cross-sectional study endeavors to assess the COVID-19 infection rate among the primary HCWs in Jiangsu Province subsequent to the implementation of adjusted epidemic prevention and control strategies.

Methods

From January 17 to February 2, 2023, an extensive survey was conducted among primary HCWs in Jiangsu Province, employing a self-designed questionnaire. Logistic regression analysis was utilized to identify the factors associated with COVID-19 infection.

Results

The overall infection rate among primary HCWs stood at 81.05%, with a 95% confidence interval (CI) of 80.61-81.48%. Among those afflicted, cough, fatigue, and fever emerged as the three most prevalent symptoms, each with an incidence rate exceeding 80%. In the context of multivariate logistic regression, an elevated risk of COVID-19 infection was observed in correlation with female gender (adjusted odds ratio [aOR] = 1.12, 95% CI: 1.04-1.21), possessing a bachelor's degree or higher (aOR = 1.32, 95% CI: 1.23-1.41), accumulating over 10 years of work experience (aOR = 1.28, 95% CI: 1.11-1.47), holding a middle-level cadre position (aOR = 1.22, 95% CI: 1.11-1.35), assuming the role of a unit leader (aOR = 1.30, 95% CI: 1.11-1.54), and working in a fever clinic for 1 to 10 days per month (aOR = 1.42, 95% CI: 1.29-1.57). Conversely, advanced age (aOR = 0.76, 95% CI: 0.70-0.82), being underweight (aOR = 0.78, 95% CI: 0.69-0.90), current smoking (aOR = 0.64, 95% CI: 0.57-0.71), receiving 4 doses of COVID-19 vaccine (aOR = 0.49, 95% CI: 0.37-0.66), and pregnancy or perinatal status (aOR = 0.85, 95% CI: 0.72-0.99) were associated with a diminished risk of infection.

Conclusion

Following the implementation of adjusted policies, a substantial proportion of primary HCWs in Jiangsu province contracted COVID-19. Female gender and younger age emerged as risk factors for COVID-19 infection, while no discernible link was established between professions and COVID-19 susceptibility. The receipt of COVID-19 vaccines demonstrated efficacy in curtailing the infection rate, underscoring the significance of bolstering prevention knowledge and heightening self-protective awareness among primary HCWs.

Analysis of influencing factors of job demands of healthcare workers working in mobile cabin hospitals in China

AIM

To explore the job demands of healthcare workers (HCWs) working in mobile cabin hospitals in Shanghai and identify the influencing factors.

DESIGN

The study had a cross-sectional design.

METHODS

Using the convenience sampling method, we selected 1223 HCWs (medical team members) working in these mobile cabin hospitals during April-May 2022. The findings of the general information questionnaire and the hierarchy scale of job demands of HCWs working in mobile cabin hospitals were used for the investigation.

RESULTS

The total score of job demands of the included HCWs was 132.26 ± 9.53; the average score of the items was 4.73 ± 0.34. Multivariate linear regression analyses showed that the following HCWs had significantly higher job demands: female HCWs and HCWs who received psychological training or intervention during the COVID-19 pandemic, were satisfied with the doctor/nurse-patient relationship, received support from family members/friends/colleagues, believed that the risk of working in mobile cabin hospitals was high, had adapted to the working environment of mobile cabin hospitals and had college/undergraduate level of education. They would benefit from increased social support and better training in terms of psychological coping mechanisms(both theoretical knowledge and applicable skills) and COVID-19 prevention,control and treatment abilities.

Epidemiologic Characteristics of SARS-CoV-2 Omicron BA.5.1.3 Variant and the Protection Provided By Inactivated Vaccination

Omicron variants have become the dominant SARS-CoV-2 variants due to their increased transmissibility and immune-escape ability. An outbreak of the Omicron variant BA.5.1.3 occurred in August 2022 in Sanya, China. Studying Omicron variants can promote the understanding of them and further contribute to managing the SARS-CoV-2 prevalence. This retrospective study analyzed the data of 258 patients with asymptomatic or mild SARS-CoV-2 admitted to the First Cabin Hospital of Sanya, China, between August 14 and September 4, 2022. The 258 patients comprised 128 males and 130 females with a mean age of 36.6 years and mean length of medical observation (LMO) of 10.1 days. Multiple linear regression analysis indicated that LMO was positively and negatively associated with age (p = 0.036) and vaccination status (p = 0.004), respectively. A Cox proportional-hazards model revealed that age (hazard ratio [HR] = 0.99, p = 0.029) and vaccination (HR = 1.23, p = 0.023) were risk and protective factors for LMO, respectively. Causal mediation analysis indicated that vaccination suppressed the effect of prolonging LMO caused by increasing age. Recovery times became longer with increasing age, which could be counterbalanced by vaccination. The present results indicate that vaccination interventions, even those developed through inactivated approaches, can still provide protection against Omicron variants.

Early oral nutritional supplement improves COVID-19 outcomes among hospitalized older patients during the Omicron wave

OBJECTIVES

The effect of and optimal timing for initiating an oral nutritional supplement(ONS) in hospitalized older patients with the Omicron variant infection remain unclear. The aim of this study was to explore the associations between the ONS and clinical outcomes.

METHODS

This study used a retrospective cohort design as primary analysis and a case-control design as sensitivity analysis. We collected data from patients with confirmed coronavirus disease 2019 (COVID-19) between April 2022 and June 2022 at Shanghai Fourth People's Hospital, one of the designated medical centers for COVID-19 in Shanghai, China. Patients were identified as ONS users or non-ONS users, with the former defined as early ONS (ONS initiated within 48 h from hospital admission), and late ONS (ONS initiated after 48 h) users.

RESULTS

The study included 1181 hospitalized patients ≥60 y of age. The mean age of the cohort was 78 y, and most patients were women (57.7%). Mortalities after propensity-score matching were 1.2% and 4.3% in the ONS group and non-ONS groups, respectively (P = 0.032). Subgroup analysis results showed that median (IQR) hospital length of stay and the median (IQR) length from symptom onset to viral clearance were shorter for the early ONS than for the late ONS group (9 [6-13] d versus 14 [11 -18] d; P < 0.001, and 11 [8-17] d versus 17 [13-22] d; P < 0.001, respectively). The findings from the case-control analysis supported those from the primary analysis.

CONCLUSIONS

Early ONS might have significantly lowered risk for in-hospital death, as well as reduce hospital length of stay and days of viral clearance in older patients with COVID-19 during the Omicron wave.

Analysis on the factors associated with COVID-19 infection among Chinese residents after the implementation of the 10 new rules to optimize COVID-19 response: a cross-sectional study

Introduction

This study aimed to investigate the status of COVID-19 infection and the associated factors among Chinese residents after the implementation of the 10 New Rules to optimize COVID response.

Methods

Participants were recruited using convenience sampling. The study used self-filled questionnaires to examine COVID-19 infection and associated factors among Chinese residents, from December 29, 2022, to January 2, 2023. For the statistical analysis, descriptive and quantitative analyses were used. The potential risk factors for COVID-19 infection were identified by multivariable logistic regression analysis.

Results

After the adjustments in control strategies against COVID-19, the infection rate of COVID-19 was high among respondents, and 98.4% of individuals who tested positive showed symptoms including cough, fever, fatigue, headache, sore throat, nasal congestion, sputum production, muscle and joint pain, and runny nose. The main problems respondents reported were the shortage of drugs and medical supplies, the increased burden on families, and the unreliable information source of COVID-19 infection. Logistic regression showed that isolating patients with COVID-19 at home was associated with a lower risk of COVID-19 infection (OR = 0.58, 95%CI: 0.42-0.81).

Conclusion

COVID-19 infection among residents is closely related to age, gender, and epidemic prevention measures. The government needs to strengthen education for individuals and centrally manage and properly address difficulties that may arise during COVID-19.

Clinical Study on the Emotional Intervention of Patients with Asymptomatic and Mild Novel Coronavirus (COVID-19)

Background and Objectives: The aim was to explore the interventional effect of the traditional Chinese medicine (TCM) exercise of Tian Dan Shugan Tiaoxi on the emotions of patients with mild novel coronavirus (COVID-19). Materials and Methods: A total of 110 asymptomatic and mildly symptomatic COVID-19 patients from Hongkou Memorial Road Temporary Cabin Hospital and South Renji Hospital were selected between April 2022 and June 2022, and randomly divided into two groups: a control group and an intervention group. There were 55 participants in each group. The control group was treated with Lianhua Qingwen granules, and members of the intervention group were made to practice Tian Dan Shugan Tiaoxi (an exercise that soothes the liver and regulates emotions) every day for 5 days. The Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder questionnaire (GAD-7), and the Symptom Checklist 90 (SCL-90) were used to evaluate the data collected before and after the trial. Results: The incidence of anxiety and depression was high in the patients included in this study, at 73.64% and 69.09%, respectively. After intervention, the scores of the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder questionnaire (GAD-7) in the two groups had decreased in comparison with those recorded before intervention (p < 0.05). The PHQ-9 and GAD-7 scores in the intervention group were significantly better than those of the control group (p < 0.05). The factors of somatization, depression, anxiety, hostility, and fear in the SCL-90 in the intervention group were significantly improved after intervention, and generally, better than those in the control group (p < 0.05). Conclusions: Patients infected with novel coronavirus in shelter hospitals have different degrees of emotional abnormalities. Tian Dan Shugan Tiaoxi can reduce the anxiety and depression of people with mild novel coronavirus, and it can be practiced clinically to improve the recovery rate among infected people.

Association between the overall burden of comorbidity and Ct values among the older patients with Omicron infection: Mediated by inflammation

Objectives

To investigate the associations between the overall burden of comorbidity, inflammatory indicators in plasma and Ct values among the elderly with COVID-19.

Methods

We conducted a retrospective observational study. The results of each nucleic acid test of during hospitalization were obtained. Linear regression models assessed the associations between the overall burden of comorbidity, inflammatory indicators in plasma and Ct values among the elderly. A causal mediation analysis was performed to assess the mediation effects of inflammatory indicators on the association between the overall burden of comorbidity and Ct values.

Results

A total of 767 COVID-19 patients aged ≥ 60 years were included between April 2022 and May 2022. Patients with a high burden of comorbidity had significantly lower Ct values of the ORF gene than subjects with a low burden of comorbidity (median, 24.81 VS 26.58, P &lt; 0.05). Linear regression models showed that a high burden of comorbidity was significantly associated with higher inflammatory responses, including white blood cell count, neutrophil count and C-reactive protein. Also, white blood cell count, neutrophil count, C-reactive protein and the overall burden of comorbidity assessed by age-adjusted Charlson comorbidity index were independent risk factors for the Ct values. A mediation analysis detected the mediation effect of white blood cells on the association between the burden of comorbidity and Ct values, with the indirect effect estimates of 0.381 (95% CI: 0.166, 0.632, P &lt; 0.001). Similarly, the indirect effect of C-reactive protein was -0.307 (95% CI: -0.645, -0.064, P = 0.034). White blood cells and C-reactive protein significantly mediated the relationship between the burden of comorbidity and Ct values by 29.56% and 18.13% of the total effect size, respectively.

Conclusions

Inflammation mediated the association between the overall burden of comorbidity and Ct values among elderly with COVID-19, which suggests that combined immunomodulatory therapies could reduce the Ct values for such patients with a high burden of comorbidity.