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Coronavirus disease 2019 (COVID-19) has been recognized as a global pandemic outbreak, opening the most severe socio-economic crisis since World War II. Different scientific activities have been emerged in this global scenario, including the development of innovative analytical tools to measure nucleic acid, antibodies, and antigens in the nasopharyngeal swab, serum, and saliva for prompt identification of COVID-19 patients and to evaluate the immune response to the vaccine. The detection of SARS-CoV-2 in saliva remains a challenge for the lack of sufficient sensitivity. To address this issue, we developed a novel paper-based immunoassay using magnetic beads to support the immunological chain and 96-well wax-printed paper plate as a platform for color visualization by using a smartphone combined with Spotxel free-charge app. To assess the reliability of the measurement of SARS-CoV-2 in saliva, untreated saliva was used as a specimen and the calibration curve demonstrated a dynamic range up to 10 μg/mL, with a detection limit equal to 0.1 μg/mL. The effectiveness of this sustainable analytical tool in saliva was evaluated by comparing the data with the nasopharyngeal swab specimens sampled by the same patients and tested with Real-Time PCR reference method, founding 100% of agreement, even in the case of high Cycle Threshold (CT) numbers (low viral load). Furthermore, the positive saliva samples were characterized by the next-generation sequencing method, demonstrating the capability to detect the Delta variant, which is actually (July 2021) the most relevant variant of concern.

Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is emerging as a global pandemic outbreak. To date, approximately one million deaths and over 32 million cases have been reported. This ongoing pandemic urgently requires an accurate testing device that can be used in the field in a fast manner. Serological assays to detect antibodies have been proven to be a great complement to the standard method of reverse transcription-polymerase chain reaction (RT-PCR), particularly after the second week of infection. We have developed a specific and sensitive immunosensor for immunoglobulin detection produced against SARS-CoV-2. Unlike other lateral flow-based assays (LFAs) involving the utilization of multiple antibodies, we have reported a label-free paper-based electrochemical platform targeting SARS-CoV-2 antibodies without the specific requirement of an antibody. The presence of SARS-CoV-2 antibodies will interrupt the redox conversion of the redox indicator, resulting in a decreased current response. This electrochemical sensor was proven effective in real clinical sera from patients with satisfactory results. In addition, the proposed format was also extended to antigen detection (the spike protein of SARS-CoV-2), which presents new possibilities for diagnosing COVID-19., Highlights • Electrochemical sensor for COVID-19 diagnostic. • Serological assay for SARS-CoV-2 antibodies was demonstrated. • Sensitivity enhancement compared to the traditional LFA devices. • Applicable to real clinical sera with satisfactory results.

Background Sudden and unpredictable changes caused by the COVID-19 pandemic have profoundly threatened the psychological well-being and increased insecurity among adolescents worldwide. At a critical developmental stage, the well-being of the youth is more vulnerable to adverse environments. This study constructed a moderated mediation model to explore the buffering factors between insecurity and subjective well-being of the youth during the pandemic. Methods During the COVID-19 outbreak in June 2020, data of 5,503 Chinese youth (15–29 years old) were collected via an online questionnaire. Subjective well-being, insecurity, self-control, and hope were measured, and the moderated mediation model was analyzed. Results Findings from this study showed that with the mediating effect of self-control, insecurity negatively predicted subjective well-being, and hope moderated the association between insecurity and self-control. Specifically, the link between insecurity and self-control was stronger when hope was low but weaker when hope was high. Limitations Since this study was mainly conducted in China, and considering the continuous change of the pandemic on a global scale, it is of great significance to conduct cross-cultural and cross-time studies in the future. Conclusions The results demonstrate that self-control and hope play important roles in buffering the negative effects of insecurity on the subjective well-being of adolescents and young adults. The findings provide implications for reducing the negative impact of insecurity from a positive psychology perspective and for youth mental health interventions during public health crises.

Background Social isolation and the impact on mental health is a major concern during COVID-19. Trait equanimity is expected to protect individuals from psychological distress associated with social isolation. The aim of this study is to examine the link between social isolation and psychological distress via the mediator equanimity. It was hypothesised that objective (few social contacts) and perceived social isolation (loneliness) would predict psychological distress and that equanimity would mediate these relationships. Methods Five hundred and seventy-eight adult United States participants were recruited and completed measures of objective social isolation and perceived social isolation (De Jong Gierveld Social Isolation scale), trait equanimity (Phenomenological Experience of Meditative Equanimity Scale), and psychological distress (Depression, Anxiety, and Stress Scale, Short Form, DASS-21). Results Objective social isolation negatively predicted psychological distress, but equanimity did not mediate this relationship. Perceived social isolation positively predicted psychological distress and equanimity mediated this relationship. Limitations This study is limited by its cross-sectional and self-report design and by a United States sample, which may affect the generalisability of findings. Conclusions Rather than a lack of social contact it is the "perceived" nature of isolation that is related to psychological distress and this relationship indirectly operates through trait equanimity. Individuals high in trait equanimity may be better protected from the impact of perceived social isolation. Clinical interventions can be adapted to include equanimity skills to mitigate perceived social isolation for individuals and reduce adverse outcomes.

Background The COVID-19 pandemic has led to significant mental health consequences for frontline health care workers (FHCWs). However, no known study has examined the prevalence, determinants, or correlates of posttraumatic growth (PTG) in this population. Methods Data were analyzed from a prospective cohort of FHCWs at an urban tertiary care hospital in New York City (NYC). Assessments were conducted during the spring 2020 pandemic peak (Wave 1) and seven months later (Wave 2). Multivariable logistic regression analyses were conducted to identify Wave 1 sociodemographic, occupational, and psychosocial factors associated with PTG at Wave 2, and the association between aspects of PTG with burnout and pandemic-related PTSD symptoms at Wave 2. Results A total 76.8% of FHCWs endorsed moderate or greater PTG; the most prevalent domains were increased appreciation of life (67.0%), improved relationships (48.7%), and greater personal strength (44.1%). Non-White race/ethnicity, greater levels of positive emotions, pandemic-related PTSD symptoms, dispositional gratitude, and feelings of inspiration were independently associated with PTG. At Wave 2, endorsement of spiritual growth during the pandemic was associated with 52% and 44% lower odds of screening positive for pandemic-related PTSD symptoms and burnout, respectively; greater improvement in relationships was associated with 36% lower odds of screening positive for burnout. Limitations Single institution study and use of self-report instruments. Conclusions Nearly 4-of-5 FHCWs report pandemic-related PTG, driven largely by salutogenic factors assessed during the pandemic surge. Interventions to bolster these factors may help promote PTG and mitigate risk for burnout and pandemic-related PTSD symptoms in this population.

Background Unpaid caregivers of adults play critical roles in health care systems by providing care to older adults and those with chronic conditions. The COVID-19 pandemic has heightened caregiving needs, forcing some into caregiving roles and disrupting others. We sought to estimate the prevalence of and identify factors associated with adverse mental health symptoms, substance use, and suicidal ideation amongst unpaid caregivers of adults versus non-caregivers. Methods During June 24-30, 2020, surveys were administered to U.S. adults. Quota sampling and survey weighting were implemented to improve sample representativeness of age, gender, and race/ethnicity. Results Of 9,896 eligible invited adults, 5,412 (54.7%) completed surveys and 5,011 (92.6%) met screening criteria and were analyzed, including 1,362 (27.2%) caregivers. Caregivers had higher adverse mental health symptom prevalences than non-caregivers, including suicidal ideation (33.4% vs 3.7%, p

Background With concern over the rise in mental health symptoms associated with the COVID-19 pandemic, the present study set out to address the absence of pandemic-specific screening tools for detecting those in Chinese societies who are at-risk for experiencing mental distress due to the pandemic; thus, its aim was to validate the Coronavirus Anxiety Scale (CAS) and Obsession with COVID-19 Scale (OCS) in Chinese adults. Methods With a two-stage cluster random sampling method, we surveyed 1011 Chinese community-dwelling adults (38.8% men; 41.2 years old on average with an SD of 15.8) in June and July of 2020. Results Our psychometric evaluation results showed that the Chinese version of CAS and OCS retained their original one-dimensional structure and demonstrated measurement invariance across genders. In line with validation studies of the CAS and OCS in other languages, subsequent analyses also provided support to our Chinese version with respect to their satisfactory internal consistency (α = .87 and .73, respectively), and good concurrent validity (i.e., positive associations with negative feelings, excessive time-consumption, subjective distress, and functioning impairment). Limitations Due to constraints of time and cross-sectional design, we only validated CAS and OCS among Chinese adults and did not evaluate their test-retest reliability nor predictive validity. Conclusions Considering the practical benefits of understanding the source of mental symptoms during the pandemic, we recommend the use of CAS and OCS in Chinese communities to facilitate early identification and intervention for those who require clinical attention due to their COVID-19 related anxiety and obsessive thoughts.

Background The mental health of racial/ethnic minority groups in the United States may be disproportionately impacted by the COVID-19 pandemic due to greater experience of peri-pandemic stressors. Yet, few studies have systematically examined racial/ethnic differences in mental health outcomes in this context. Methods Data came from the COVID-19 Southern Cities Study, a probability-based, cross-sectional study conducted in May/June 2020 among adults living in the metropolitan statistical areas of Atlanta, Austin, Dallas, Houston, and New Orleans. Unadjusted and adjusted associations between racial/ethnic identity and past-week depression and/or anxiety symptoms (Patient Health Questionnaire-2 score ≥ 3 or Generalized Anxiety Disorder-2 score ≥ 3), trouble sleeping, physical reactions when thinking about COVID-19, and self-rated worsened mental health due to the pandemic were estimated in separate logistic regression models. Results Over 30% of respondents reported depression and/or anxiety symptoms, 21% reported physical reactions, 25% had trouble sleeping, and 33% worsened mental health since the pandemic began. Adjusting for sociodemographic and health-related characteristics and pandemic-related stressors, odds of anxiety symptoms (odds ratio (OR) 0.53, 95% confidence interval (CI) 0.30–0.95) and worsened mental health (OR 0.58, 95% CI 0.36–0.94) were lower among non-Hispanic Black vs. non-Hispanic white respondents. Limitations No diagnostic assessments were used, and results may not be generalizable to later phases of the pandemic and the entire U.S. South. Conclusions Despite greater pandemic-related stressor experience, poor mental health outcomes were not more common among racial/ethnic minority individuals. However, interventions to reduce disparities in stressor experience and promote mental health are needed.

Background: The 2019 coronavirus disease (COVID-19) pandemic has impacted the mental health and well-being of medical personnel, including nursing students. Network analysis provides a deeper characterization of symptom-symptom interactions in mental disorders. The aim of this study was to elucidate characteristics of anxiety and depressive symptom networks of Chinese nursing students during the COVID-19 pandemic. Method: A total of 932 nursing students were included. Anxiety and depressive symptom were measured using the seven-item Generalized Anxiety Disorder Scale (GAD-7) and two-item Patient Health Questionnaire (PHQ-2), respectively. Central symptoms and bridge symptoms were identified via centrality indices and bridge centrality indices, respectively. Network stability was examined using the case-dropping procedure. Results: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood had the highest centrality values. Three bridge symptoms (Depressed mood, Nervousness, and Anhedonia) were also identified. Neither gender nor region of residence was associated with network global strength, distribution of edge weights or individual edge weights. Limitations: Data were collected in a cross-sectional study design, therefore, causal relations and dynamic changes between anxiety and depressive symptoms over time could not be inferred. Generalizability of findings may be limited to Chinese nursing students during a particular phase of the current pandemic. Conclusions: Irritability, Uncontrollable worry, Trouble relaxing, and Depressed mood constituted central symptoms maintaining the anxiety-depression network structure of Chinese nursing students during the pandemic. Timely, systemic multi-level interventions targeting central symptoms and bridge symptoms may be effective in alleviating co-occurring experiences of anxiety and depression in this population.

Background COVID-19 has introduced novel stressors into American adolescents’ lives. Studies have shown that adolescents adopt an array of coping mechanisms and social supports when contending with stress. It is unclear, though, which strategies are most effective in mitigating daily pandemic-related stress, as few micro-longitudinal studies have explored adolescents’ daily affect during COVID-19. Parental support may also be a critical component of adolescents’ pandemic-related coping, as adolescents’ peer networks have been limited by public health measures. Methods This longitudinal study examined links between stress, coping, parental support, and affect across 14 consecutive days and 6216 assessments from a national sample of adolescents (N=444; Mage=15.0; 60% female; 44% Black/African American, 39% White/Europen American, 9% Latinx, 6% Asian American, 2% Native American) during school closures and state-mandated stay-at-home orders between April 8 and April 21, 2021. Results Adolescents’ health and financial stress predicted increases in same-day (health stress’ effect size = .16; financial stress’ effect size = .11) and next-day negative affect (health stress’ effect size = .05; financial stress’ effect size = .08). Adolescents’ secondary control engagement coping predicted increases in same-day (effect size = .10) and next-day (effect size = .04) positive affect and moderated the link between health stress and negative affect. Parental social support predicted increases in same-day (effect size = .26) and next-day (effect size = .06) positive affect and decreases in same-day (effect size = .17) negative affect and moderated the link between financial stress and negative affect. Limitations Results are indicative of conditions at the immediate onset of COVID-19 and should be interpreted as such. Conclusions Findings provide information as to how health providers and parents can help adolescents mitigate the impact of COVID-19-related health and economic stressors on their psychological well-being. It remains critical to monitor the psychosocial impact of the pandemic on adolescents’ affect while continuing to identify personal and environmental protective factors for reducing harm and maximizing resilience.

The COVID-19 pandemic and lockdown measures have had a profound impact on the emotions, anxiety, and mental health of affected communities. Despite this, there is a lack of knowledge about the possible generational and geographical differences in the effects on the mental health of individuals. This study examines the impact of COVID-19 related quarantine on symptoms of generalized anxiety disorders (GAD) among parents and children (N = 4503). It also compares the outcomes of residents from the initial COVID-19 epicenter of Wuhan to those in surrounding areas. Subgroup analyses were conducted by child and parent samples, and by Wuhan city and other cities in the Hubei province. Propensity score radius matching and ordinary least squares regressions were used to examine the relationship between quarantine and GAD symptoms. Results showed that quarantine had more psychological impact on parents than children, regardless of geographic location. Parents that experienced quarantine in Wuhan city, reported a significantly higher level of symptoms of GAD than those that did not. Parents from other cities showed no such difference. For both children and parents, interpersonal communication about COVID-19 and social media exposure to pandemic-related information were linked to GAD symptoms. Targeted policies and interventions are needed to address the psychological impacts of COVID-19 lockdown.

Background The potential benefits of the COVID-19 lockdown need to be carefully weighed versus the possible impact on people's daily life and negative mental health effects.We aimed to assess the prevalence of depression, anxiety, insomnia and quality of life before and during the COVID-19 lockdown,identifying subgroups at higher risk of mental distress as a consequence of COVID-19 associated restrictions. Methods Within the Lost in Italy project, a web-based cross-sectional study was conducted on a representative sample of 6003 Italian adults aged 18–74 recruited from April 27 to May 3, 2020, within the nation-wide stay-at-home order. Results The prevalence of depressive symptoms (PHQ-2 ≥ 3) increased from 14.3% before lockdown to 33.2% during lockdown, anxiety symptoms (GAD-2 ≥ 3) from 18.1% to 41.5%, insufficient sleep (≤6 h/day) from 33.7% to 41.1%, unsatisfactory sleep from 17.0% to 38.8% and unsatisfactory quality of life from 13.1% to 42.1%.Overall, 47.7% reported worsened depressive symptoms, 43.6% worsened anxiety symptoms, sleep quantity (31.5%) and quality (35.0%),and 64.1% worsened quality of life.A statistically significant relationship with all mental health outcomes considered was found for women vs. men (multivariate odds ratio,OR between 1.13 and 1.63), for current vs. never smokers (OR between 1.15 and 1.25), and with increasing physical activity (p for trend

Highlights • The prevalence of depression among Chinese pregnant women was 35.4%. • Drinking, morning sickness, and limited activity were risk factors for depression. • Less attention to fetal movement every day was also a risk factor for depression., Background The prevalence of depression increase with the outbreaks of epidemic disease. The prevalence of depression during the outbreak of Corona Virus Disease 2019 (COVID-19) in prenatal and postnatal women was examined in China. Methods 2201 prenatal and postnatal women in mainland China were recruited in this cross-sectional study from February 28th to April 26th, 2020. The Patient Health Questionnaire (PHQ-9) was used to assess depression in prenatal and postnatal women. Results The prevalence rate of depression was 35.4%. The risk factors for depression included drinking (p = 0.04; adjusted OR = 2.81, 95%CI: 1.26~6.24), nausea and vomiting during pregnancy (p

BACKGROUND: It is unclear how those with bipolar disorder (BD) have been affected by the coronavirus (COVID-19) pandemic. This study aimed to obtain a more detailed understanding of the current mental health needs of these individuals, which is important for both the development of intervention strategies to better manage patient distress and to better prepare for similar circumstances in future. METHODS: The sample comprised 43 individuals with a verified diagnosis of BD and 24 healthy controls. Data about pandemic-related mental health support use, socio-demographics, mood, lifestyle, social rhythm and subjective cognitive dysfunction data were collected and compared between groups. Inter-relationships between scores were also examined. RESULTS: No between-group differences were found in terms of age, sex, living situation, job loss or reduced work hours due to COVID-19. Most patients with BD reported a history of ongoing formal psychological support (68.3%), with most continuing this support throughout the pandemic (82.1%). A large, statistically significant pandemic-related increase in subjective cognitive dysfunction was evident in the BD group. Subjective cognitive dysfunction was significantly associated with negative symptomology, suicidal thoughts, and quality of life ratings. LIMITATIONS: Data was collected in self-report format in an online survey and objective symptom measures were not used at this time CONCLUSION: The absenceof substantial differences between patients and controls in terms of mood symptoms, COVID-19 fear or lifestyle factors and social rhythms suggests a degree of resilience in BD patients; despite large pandemic related increases in subjective cognitive dysfunction.

Highlights • A two-factor structure applied to participants’ coping strategies, namely problem-focused coping and emotion-focused coping, and the former was more adopted. • Problem-focused coping was associated with less cyberbullying behaviors while had no correlation with depression. • Emotion-focused coping was found positively correlated with cyberbullying and depression. • The association between emotion-focused coping and depression was mediated by cyberbullying., Background: As a major life stressor now, the COVID-19 pandemic could substantially increase risks of cyberbullying and depression for global people, especially in the context of increased digital interconnectedness and strict social distancing. Though people are adopting different coping strategies, still little is known about their cyberbullying and depression and how the two associated with coping strategies. Methods: A web-based nationwide questionnaire survey was conducted among 5,608 netizens during the peak time of COVID-19 in China. The study collected cross-sectional data on participants’ coping strategies, general cyberbullying behaviors, cyberbullying behaviors specifically to residents of Hubei Province where first COVID-19 case was reported, and depression. Results: A two-factor structure applied to participants’ coping strategies, namely problem-focused coping and emotion-focused coping, and the former was more adopted. There existed gender, age, education, and income differences in the coping strategies. Problem-focused coping was associated with less cyberbullying behaviors while had no correlation with depression; emotion-focused coping was found positively correlated with cyberbullying and depression. The association between emotion-focused coping and depression was mediated by cyberbullying. Limitations: The study used cross-sectional design, and its findings should be cautioned to be generalized to other countries, due to the differences in culture, stage of crisis, and government policies on COVID-19. Conclusions: Problem-focused coping was associated with less cyberbullying, and emotion-focused coping predicted cyberbullying and depression. Cyberbullying mediated the correlation between emotion-focused coping and depression. These findings provide new perspectives for interventions on people's coping strategies towards COVID-19 pandemic.

Highlights • A retrospective analysis was performed of all patients admitted to the Psychiatric Emergency Service 90 days before and after March 14th, 2020, the first day of lockdown in Spain due to COVID-19. • During the lockdown the number of admissions decreased by 37.9% while a significant increase in the percentage of patients requiring acute psychiatric hospitalization was observed. • Anxiety spectrum disorders accumulated the greatest decrease in admission rates compared to the three months before lockdown. • A statistically significant increase in admissions rates was found in patients with dementia-like cognitive impairments, autism spectrum, and substance use disorders during the lockdown., Background During the COVID-19 pandemic, a structural reorganization was imposed on public health systems. Psychiatry services were also affected with the imposed reduction of non-urgent consultations. We aim to explore the effect of these changes on a Psychiatry Emergency Service during COVID-19 lockdown in Spain. Methods A retrospective analysis was performed on all patients admitted to our Psychiatric Emergency Service 90 days before and after March 14th, 2020, the first day of lockdown in Spain. Extracted data were compared between the two periods. Poisson regression analysis was performed to analyze changes in admission rates. Results 1,958 psychiatric emergency admissions were analyzed. Although the number of admissions decreased by 37.9%, we observed a significant increase in the percentage of acute psychiatric hospitalization during the lockdown. Anxiety spectrum disorders accumulated the greatest significant decrease in admission rates during the lockdown. On the other hand, a significant increase in admissions rates was found in patients with dementia, autism spectrum disorders, and substance use disorders during the lockdown. Limitations This study was conducted in a single psychiatric emergency service, preventing a generalization of our results. The comparison time period might have biased our results due to the influence of external factors. Conclusion Mental health consequences of COVID-19 are becoming apparent. A reduction of admission rates for anxiety disorders might be related telepsychiatry implementation during the lockdown. Other conditions particularly vulnerable to the routine changes and lack of social support have suffered the most, and efforts should be placed to treat these situations.

Highlights • HCWs in Egypt and Saudi-Arabia experienced depression, anxiety, and stress during the COVID-19 pandemic. • Female sex, age ≤30 years, attending night shifts, and watching/reading COVID-19 news associated with worse psychological disturbances. • Providing psychological support to HCWs during the COVID-19 pandemic is an urgent need., Introduction As the Novel Corona Virus Disease (COVID-19) was declared by the world health organization a pandemic in March 2020, thousands of healthcare workers (HCWs) worldwide were on the frontlines fighting against the pandemic. Herein, we selected two Middle East countries; Egypt and Saudi Arabia to investigate the psychological impacts of the COVID-19 pandemic on their HCWs. Methods In this cross-sectional study, a Google survey was used to access HCWs in many hospitals in Egypt and Saudi Arabia between the 14th and 24th of April 2020. The survey assessed HCWs regarding their sociodemographic and occupational features, sleeping hours, and psychological impacts of the COVID-19 pandemic using the Depression Anxiety Stress Scale-21 (DASS-21). Results This study included 426 HCWs (48.4% physicians, 24.2% nurses, and 27.4% other HCWs). Of them, 69% had depression, 58.9% had anxiety, 55.9% had stress, and 37.3% had inadequate sleeping (

Background We aimed to estimate the population prevalence of people with changes in their usual patterns of alcohol use during the early stages of the novel coronavirus pandemic of 2020 (COVID-19) pandemic in Australia; assess the association between mental health status and changes in alcohol use during the pandemic; and examine if the associations were modified by gender and age. Methods This study was an anonymously-completed online self-report survey. Changes in alcohol use were assessed using a single fixed-choice study-specific question. Mental health was assessed using the Patient Health Questionnaire 9 and the Generalized Anxiety Disorder Scale. Results A total of 13,829 people contributed complete data and were included in the analysis. Overall, about one in five adults reported that they had been drinking more alcohol since the COVID-19 pandemic began than they used to. People were more likely to be drinking alcohol more than they used to if they had more severe symptoms of depression or anxiety. The associations between depressive and anxiety symptoms and increased alcohol use since the COVID-19 pandemic began were consistent between females and males. Limitations Online surveys are less accessible to some groups of people. The data are self-report and not diagnostic. Cross-sectional data can identify associations, not causal relationships. The study was limited to participants from Australia. Conclusions These data indicate that there is a need for public policies focused on alcohol use during the COVID-19 pandemic and the strategies should include specific consideration of the needs of people with mental health problems.

Highlights • The estimated self-reported rates of anxiety symptoms and depression symptoms among medical staff were 13.3% and 18.4% respectively under COVID-19 epidemic. • Up to 23.9% investigated medical staff reported having anxiety or depression symptoms. • Psychological interventions for medical staff should be integrated into the strategies for fighting COVID-19., Background It is well known that unexpected pandemic has led to an increase in mental health problems among a variety of populations. Methods In this study, an online non-probability sample survey was used to anonymously investigate the anxiety and depression symptoms among medical staff under the COVID-19 outbreak. The questionnaire included Perceived Stress Scale-10 (PSS-10), Generalized Anxiety Disorder 7-Item Scale (GAD-7) and Patient Health Questionnaire-9 (PHQ-9). Factors associated with anxiety and depression symptoms were estimated by logistic regression analysis. Results A total of 1090 medical staff were investigated in this study. The estimated self-reported rates of anxiety symptoms, depression symptoms and both of the two were 13.3%, 18.4% and 23.9% respectively. Factors associated with self-reported anxiety symptoms include married status (OR=2.3, 95%CI: 1.2, 4.4), not living alone (OR=0.4, 95%CI: 0.2, 0.7), never confiding their troubles to others (OR=2.2, 95%CI: 1.4, 3.5) and higher stress (OR=14.4, 95%CI: 7.8, 26.4). Factors associated with self-reported depression symptoms include not living alone (OR=0.4, 95%CI: 0.3, 0.7), sometimes/often getting care from neighbours (OR=0.6, 95%CI: 0.4, 0.9), never confiding their troubles to others (OR=2.0, 95%CI: 1.3, 3.0) and higher stress (OR=9.7, 95%CI: 6.2, 15.2). Limitations The study was a non-probability sample survey. Besides, scales used in this study can only identify mental health states. Conclusions Under outbreak of COVID-19, self-reported rates of anxiety symptoms and depression symptoms were high in investigated medical staff. Psychological interventions for those at high risk with common mental problems should be integrated into the work plan to fight against the epidemic.

Highlights • Students report moderate-to-severe psychological impact of the COVID-19 pandemic. • Timely and adequate health information has protective psychological effect. • Health care workers are less likely to be psychologically affected. • Home quarantine is associated with depression, anxiety and stress symptoms., Background The 2019 coronavirus disease (COVID-19) pandemic poses a threat to societies’ mental health. This study examined the prevalence of psychiatric symptoms and identified the factors contributing to psychological impact in the Philippines. Methods A total of 1879 completed online surveys were gathered from March 28-April 12, 2020. Collected data included socio-demographics, health status, contact history, COVID-19 knowledge and concerns, precautionary measures, information needs, the Depression, Anxiety and Stress Scales (DASS-21) and the Impact of Events Scale-Revised (IES-R) ratings. Results The IES-R mean score was 19.57 (SD=13.12) while the DASS-21 mean score was 25.94 (SD=20.59). In total, 16.3% of respondents rated the psychological impact of the outbreak as moderate-to-severe; 16.9% reported moderate-to-severe depressive symptoms; 28.8% had moderate-to-severe anxiety levels; and 13.4% had moderate-to-severe stress levels. Female gender; youth age; single status; students; specific symptoms; recent imposed quarantine; prolonged home-stay; and reports of poor health status, unnecessary worry, concerns for family members, and discrimination were significantly associated with greater psychological impact of the pandemic and higher levels of stress, anxiety and depression (p

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA transmission route was thoroughly investigated in the hospital wastewater, sewage collection network, and wastewater treatment plants. Samples were taken on four occasions from December 2020 to April 2021. The performance of two different wastewater treatment processes of sequencing batch reactor (SBR) and conventional activated sludge (CAS) was studied for virus destruction. For this purpose, liquid phase, solid phase and bioaerosol samples were taken from different units of the investigated wastewater treatment plants (WWTPs). The results revealed that all untreated hospital wastewater samples were positive for SARS-CoV-2 RNA. The virus detection frequency increased when the number of hospitalized cases increased. Detection of viral RNA in the wastewater collection system exhibited higher load of virus in the generated wastewater in areas with poor socioeconomic conditions. Virus detection in the emitted bioaerosols in WWTPs showed that bioaerosols released from CAS with surface aeration contains SARS-CoV-2 RNA posing a potential threat to the working staff of the WWTPs. However, no viral RNA was detected in the bioaerosols of the SBR with diffused aeration system. Investigation of SARS-CoV-2 RNA in WWTPs showed high affinity of the virus to be accumulated in biosolids rather than transporting via liquid phase. Following the fate of virus in sludge revealed that it is completely destructed in anaerobic sludge treatment process. Therefore, based on the results of the present study, it can be concluded that receiving water resources could not be contaminated with virus, if the wastewater treatment processes work properly., Graphical abstract Unlabelled Image

Dexamethasone (Dex) is used in drug regimen for treatment of Coronavirus disease (COVID-19). Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) fusion and entry into the cell occurs at pH 5.5. In our present study, we have identified a green, cheap clay based halloysite (Hal) nanoformulation with release capability of Dex at such interactive pH condition. 30%ZnFe2O4/Hal and 30%NiFe2O4/Hal were prepared by one-pot synthesis technique. Dex (5% wt/wt) was functionalized over both nanocomposites. Finally, polyethylene glycol (PEG) was coated over ZnFe2O4/Hal/Dex and NiFe2O4/Hal/Dex nanocomposite using lyophilization technique (0.08 μl/mg of nanocarrier). The release ability of Dex was studied under pulmonary infection and normal pH conditions (pH = 5.6 and 7.4). The characterization study using X-ray diffraction (XRD) and UV-visible diffuse reflectance (DRS) spectra confirmed the presence of spinel ferrites over Hal. Nitrogen adsorption isotherm showed the surface area of ZnFe2O4/Hal (75 m2/g), pore volume (0.27 cm3/g) with average pore size (14.5 nm). Scanning electron microscope/Energy dispersive spectroscopy (SEM-EDS) and Transmission electron microscopy analysis revealed a textural change in halloysite tubular type indicating drug adsorption and PEG adhesion. DRS spectra indicated an intergrowth of zinc ferrite nanoparticles on the halloysite nanotubes. Interestingly, ZnFe2O4/Hal/Dex/PEG exhibited a high Dex release ability (17.5%, 168 h) at pH = 5.6 relevant to SARS-CoV-2 fusion entry into the cell pH condition of 5.5. Comparatively, the nanocomposite showed a less Dex release (

During the COVID-19 pandemic, exposure to COVID-related stimuli, has been enormous. Exposure to threat-related stimuli, can have a significant impact on people's wellbeing particularly in relation to COVID-related anxiety. The present research comprises two empirical studies. In Study 1, a newly developed Emotional Stroop Task (EST) and an Image Rating Task (IRT) were used to assess, automatic and non-automatic affective responses to COVID-related words and images during the first wave of the pandemic in the UK general population. In Study 2, the same tasks were used to evaluate the affective responses of University students during the second wave of the pandemic. Additionally, loneliness and pro-social behaviours were explored in relation COVID-related anxiety in the same population. Overall, the results showed that automatic affective responses as measured by interference effects on the EST, remained unaffected during the pandemic. However, non-automatic affective responses to COVID-related images measured by the IRT, indicated that participants rated these images as more fearful sadder and higher in anger, compared to non-COVID negative images matched for arousal and negativity and this was more evident in people with high COVID-anxiety. Trait anxiety was related to higher levels of loneliness, more prosocial behaviour and higher intentions to help others, while COVID-related anxiety mediated these effects, suggesting that for high levels of trait anxiety, participants were more likely to have helped someone in need during the pandemic when their COVID-anxiety levels were low.

Highlights • First study to examine the contribution of the Big 5 personality traits, health anxiety, and COVID-19 psychological distress to generalised anxiety and depressive symptoms. • COVID-19 psychological distress predicts generalised anxiety and depressive symptoms beyond all other variables. • Specific personality traits appear to be protective of COVID-19 psychological distress., In the current study we sought to extend our understanding of vulnerability and protective factors (the Big Five personality traits, health anxiety, and COVID-19 psychological distress) in predicting generalised anxiety and depressive symptoms during the COVID-19 pandemic. Participants (n = 502), who were United States residents, completed a variety of sociodemographic questions and the following questionnaires: Big Five Inventory‐10 (BFI-10), Whitley Index 7 (WI-7), Coronavirus Anxiety Scale (CAS), COVID-19 Anxiety Syndrome Scale (C19-ASS), and Patient Health Questionnaire Anxiety and Depression Scale (PHQ-ADS). Results showed that extraversion, agreeableness, conscientiousness, and openness were negatively correlated with generalised anxiety and depressive symptoms and that neuroticism, health anxiety and both measures of COVID-19 psychological distress were positively correlated with generalised anxiety and depressive symptoms. We used path analysis to determine the pattern of relationships specified by the theoretical model we proposed. Results showed that health anxiety, COVID-19 anxiety, and the COVID-19 anxiety syndrome partially mediated the relationship between the Big Five personality traits and generalised anxiety and depressive symptoms. Specifically, extraversion, agreeableness, and conscientiousness were negatively associated with the three mediators, which, in turn, were positively associated with generalised anxiety and depressive symptoms, with COVID-19 anxiety showing the strongest effect. Conversely, neuroticism and openness were positively associated with COVID-19 anxiety and the COVID-19 anxiety syndrome, respectively. These relationships were independent of age, gender, employment status and risk status. The model accounted for a substantial variance of generalised anxiety and depression symptoms (R2 = .75). The implications of these findings are discussed.

Aims The recent outbreak of COVID-19 has become a global health concern. There are currently no effective treatment strategies and vaccines for the treatment or prevention of this fatal disease. The current study aims to determine promising treatment options for the COVID-19 through a computational drug repurposing approach. Materials and methods In this study, we focus on differentially expressed genes (DEGs), detected in SARS-CoV-2 infected cell lines including “the primary human lung epithelial cell line NHBE” and “the transformed lung alveolar cell line A549”. Next, the identified DEGs are used in the connectivity map (CMap) analysis to identify similarly acting therapeutic candidates. Furthermore, to interpret lists of DEGs, pathway enrichment and protein network analysis are performed. Genes are categorized into easily interpretable pathways based on their biological functions, and overrepresentation of each pathway is tested in comparison to what is expected randomly. Key findings The results suggest the effectiveness of lansoprazole, folic acid, sulfamonomethoxine, tolnaftate, diclofenamide, halcinonide, saquinavir, metronidazole, ebselen, lidocaine and benzocaine, histone deacetylase (HDAC) inhibitors, heat shock protein 90 (HSP90) inhibitors, and many other clinically approved drugs as potent drugs against COVID-19 outbreak. Significance Making new drugs remain a lengthy process, so the drug repurposing approach provides an insight into the therapeutics that might be helpful in this pandemic. In this study, pathway enrichment and protein network analysis are also performed, and the effectiveness of some drugs obtained from the CMap analysis has been investigated according to previous researches., Highlights • Computational genomics analysis can accelerate drug discovery for the COVID-19. • SARS-CoV-2 transcriptome showed a chemokine-dominant hyperinflammatory response. • Robust IFN response with significant expression of ISGs pathway is seen in COVID-19. • The drug repurposing can be used as an alternative to de novo drug development. • Many approved drugs and investigational compounds showed antiviral properties.

SARS-CoV-2 genetic material is detectable in the faeces of a considerable part of COVID-19 cases and hence, in municipal wastewater. This fact was confirmed early during the spread of the COVID-19 pandemic and prompted several studies that proposed monitoring its incidence by wastewater. This paper studies the fate of SARS-CoV-2 genetic material in wastewater treatment plants using RT-qPCR with a two-fold goal: i) to check its presence in the water effluent and in the produced sludge and ii) based on the understanding of the virus particles fate, to identify the most suitable spots for detecting the incidence of COVID-19 and monitor its evolution. On the grounds of the affinity of enveloped virus towards biosolids, we hypothesized that the sludge line acts as a concentrator of SARS-CoV-2 genetic material. Sampling several spots in primary, secondary and sludge treatment at the Ourense (Spain) WWTP in 5 different days showed that, in effect, most of SARS-CoV-2 particles cannot be detected in the water effluent as they are retained by the sludge line. We identified the sludge thickener as a suitable spot for detecting SARS-CoV-2 particles thanks to its higher solids concentration (more virus particles) and longer residence time (less sensitive to dilution caused by precipitation). These findings could be useful to develop a suitable strategy for early warning of COVID-19 incidence based on WWTP monitoring., Graphical abstract Unlabelled Image

Background: The initial period of COVID-19-related restrictions affected substance use in some population groups. We explored how changes in alcohol use at the beginning of the pandemic impacted the health and well-being of people with and without mental health and neurodevelopmental conditions (MHDCs). Methods: Data came from the Global Drug Survey Special Edition on COVID-19 conducted in May-June 2020. Measured were; changes in drinking compared to February 2020 (pre-COVID-19 restrictions), reasons for changes, and impact on physical health, mental health, relationships, finances, work/study, and enjoyment. This study included 38,141 respondents (median age = 32 IQR 25-45; 51.9% cis man; 47.8% cis woman; 1.2% trans/non-binary; 30.2% with MHDCs e.g. depression 20.0%, anxiety 16.3%, ADHD 3.8%, PTSD 3.3%). Results: A third (35.3%) of respondents with MHDCs and 17.8% without MHDCs indicated that increased drinking affected their mental health negatively (p

Black Americans have been disproportionately affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or COVID-19) pandemic. Since the pandemic's start, we have observed compounded health, social, and economic impacts for communities of color, fueled in part by profound residential segregation in the United States that, for centuries prior to the pandemic, created differences in access to opportunity and resources. Based on a longitudinal cohort of Black residents living in two racially isolated Pittsburgh neighborhoods, we sought to: 1) describe the experiences of behavioral responses to COVID-19 conditions (e.g., closures of businesses, schools, government offices) and illness experiences reported by residents within these disinvested, urban areas and 2) determine if these experiences were associated with perceptions of risk, negative mental health outcomes, and food insecurity; and 3) examine whether any of the associations were explained by social isolation or modified by neighborhood walkability. We found direct associations between residents' experience with COVID-19-related closures and with the illness, with perceived risk, and change in psychological distress, sleep quality, and food insecurity from pre-COVID-19 levels. Social isolation was a statistically significant mediator of all of these associations, most strongly mediating the pathway to psychological distress. We found neighborhood walkability to be a significant moderator of the association between closure experiences and sleep quality. The results suggest that experiences of COVID-19 closures and illness were associated with serious threats to public health in Black, disinvested, urban neighborhoods, beyond those caused directly by the virus. Outcomes of the pandemic appear very much dependent on the extent to which social and physical resources are available to meet the demands of stress.