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Background: Human communities suffered a vast socioeconomic burden in dealing with the pandemic of coronavirus disease 2019 (COVID-19) globally. Real-word data about these burdens can inform governments about evidence-based resource allocation and prioritization. The aim of this scoping review was to map the cost-of-illness (CoI) studies associated with COVID-19. Methods: This scoping review was conducted from January 2019 to December 2021. We searched cost-of-illness papers published in English within Web of Sciences, PubMed, Google Scholar, Scopus, Science Direct and ProQuest. For each eligible study, extracted data included country, publication year, study period, study design, epidemiological approach, costing method, cost type, cost identification, sensitivity analysis, estimated unit cost and national burden. All of the analyses were applied in Excel software. Results: 2352 records were found after the search strategy application, finally 28 articles met the inclusion criteria and were included in the review. Most of the studies were done in the United States, Turkey, and China. The prevalence-based approach was the most common in the studies, and most of studies also used Hospital Information System data (HIS). There were noticeable differences in the costing methods and the cost identification. The average cost of hospitalization per patient per day ranged from 101$ in Turkey to 2,364$ in the United States. Among the studies, 82.1% estimated particularly direct medical costs, 3.6% only indirect costs, and 14.3% both direct and indirect costs. Conclusion: The economic burden of COVID-19 varies from country to country. The majority of CoI studies estimated direct medical costs associated with COVID-19 and there is a paucity of evidence for direct non-medical, indirect, and intangible costs, which we recommend for future studies. To create homogeneity in CoI studies, we suggest researchers follow a conceptual framework and critical appraisal checklist of cost-of-illness (CoI) studies. [ABSTRACT FROM AUTHOR]

Background: China issued strict nationwide guidelines to combat the COVID-19 outbreak in January 2020 and gradually loosened the restrictions on movement in early March. Little is known about how these disease control measures affected the 600 million people who live in rural China. The goal of this paper is to document the quarantine measures implemented in rural China outside the epicenter of Hubei Province and to assess the socioeconomic effect of the measures on rural communities over time. Methods: We conducted three rounds of interviews with informants from 726 villages in seven provinces, accounting for over 25% of China's overall rural population. The survey collected data on rural quarantine implementation; COVID-19 infections and deaths in the survey villages; and effects of the quarantine on employment, income, education, health care, and government policies to address any negative impacts. The empirical findings of the work established that strict quarantine measures were implemented in rural villages throughout China in February. Results: There was little spread of COVID-19 in rural communities: an infection rate of 0.001% and zero deaths reported in our sample. However, there were negative social and economic outcomes, including high rates of unemployment, falling household income, rising prices, and disrupted student learning. Health care was generally accessible, but many delayed their non-COVID-19 health care due to the quarantine measures. Only 20% of villagers received any form of local government aid, and only 11% of villages received financial subsidies. There were no reports of national government aid programs that targeted rural villagers in the sample areas. Conclusions: By examining the economic and social effects of the COVID-19 restrictions in rural communities, this study will help to guide other middle- and low-income countries in their containment and restorative processes. Without consideration for economically vulnerable populations, economic hardships and poverty will likely continue to have a negative impact on the most susceptible communities. [ABSTRACT FROM AUTHOR]

Background: COVID-19 and the subsequent intermittent lockdown measures from 2020 to 2022 in China critically disrupted regular medical activities, including dental care. This study aimed to investigate the impact of COVID-19 on long-term follow-up at the Stomatology Hospital, Zhejiang University School of Medicine and to evaluate potential causes of loss to follow-up. Methods: A total of 1062 patients with periodontitis who visited the hospital from January 2019 to June 2022 were included in this study, and patient information was collected retrospectively in the form of a telephone questionnaire. The questionnaire consisted of 19 questions in four areas: demographic characteristics, clinical periodontal parameters, oral hygiene habits, and follow-up-related open-ended questions (specific reasons for loss to follow-up, attitudes toward follow-up and suggestions for increasing participation in future follow-ups). Regression analysis of factors influencing the follow-up of patients with periodontitis were analyzed by regression analysis using R (v4.2.3) software. Results: A total of 536 (50.47%) valid questionnaires were collected from 1062 patients. Personal factors (42.5%), instead of the COVID-19 epidemic (20.0%), were the main factors that impacted the loss to follow-up in long-term periodontal treatment, while work factors (19.8%), hospital factors (16.4%), and transportation or distance factors (14.7%) were all important factors. A family history of periodontitis [odds ratio (OR) = 0.567, 95% confidence interval (CI): 0.393, 0.817, p = 0.002], as well as frequent use of dental devices (OR = 0.540, 95% CI: 0.375, 0.777, p = 0.001), were significantly associated with a "negative" attitude toward follow-up visits. Conclusion: This survey suggests that the COVID-19 epidemic factor was an important cause contributed to the loss to follow-up during supportive periodontal therapy (SPT) among a variety of potential factors. Majority of patients had negative attitudes toward subsequent continued participation in supportive care. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has had major ramifications for health and the economy at both the individual and collective levels. This study examined exogenous negative changes in household income and their implications on psychological well-being (PWB) among the Chinese population during the COVID-19 pandemic. Methods: Data were drawn from the early China COVID-19 Survey, a cross-sectional anonymous online survey administered to the general population in China. Self-reported PWB was measured using a 5-point Likert scale with five questions related to the participants' recent psychological state. Hierarchical multiple linear regression was employed to examine whether income loss during the COVID-19 pandemic was associated with poor psychological health. Results: This study included 8,428 adults, of which 90% had suffered from a moderate or severe loss of household income due to the early COVID-19 pandemic. Those who had experienced moderate or severe loss of income scored significantly lower on psychological well-being than those who did not experience income loss (19.96 or 18.07 vs. 21.46; P < 0.001); after controlling for confounders, income loss was negatively associated with PWB scores (moderate income loss: B = − 0.603, P < 0.001; severe income loss: B = − 1.261, P < 0.001). An interaction effect existed between the degree of income loss and pre-pandemic income groups. Specifically, participants in the middle-income group who had suffered severe income loss scored the lowest on PWB (B = − 1.529, P < 0.001). There was also a main effect on income loss, such that participants with varying degrees of income loss differed across five dimensions, including anhedonia, sleep problems, irritability or anger, difficulty with concentration, and repeated disturbing dreams related to COVID-19. Conclusions: Income loss during the pandemic has had detrimental consequences on psychological well-being, and the magnitude of the impact of income loss on psychological well-being varied according to previous income levels. Future policy efforts should be directed toward improving the psychological well-being of the economically vulnerable and helping them recover from lost income in the shortest time possible. [ABSTRACT FROM AUTHOR]

Background: COVID-19 has spread worldwide. Older adults are at the greatest risk of contracting and dying from the virus. Nursing homes are densely populated places for older adults who are generally vulnerable and at high-risk. Although Chinese nursing homes have been trying to protect their residents, the needs and expectations of the residents and their families have been ignored. This study aimed to promote the safety of NH residents, including their physical and psychological safety, and to meet their expectations during the COVID-19 pandemic in China. Methods: Data were collected through face-to-face semi-structured interviews with nursing home residents and focus group online interviews with family members between June 2021 and February 2022. Data analysis was performed using inductive content analysis. Results: 16 residents and 24 family members were interviewed. Four themes with 10 sub-themes were identified from the participants' descriptions. Their expectations were mainly focused on prevention and control measures for COVID-19, medical capacity of nursing homes, health literacy and expectations for some aged care policies. Conclusions: In the face of concerns about the impact of COVID-19 on nursing homes, we sought to bring firsthand perspectives to the forefront by interviewing residents and their family members about their expectations for safety to address this issue. Our findings provide important areas on which should be focused and may improve the sense of gain, happiness, and security of nursing home residents during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has brought an opportunity to increase investment in the nursing practice environment, which has greatly impacted patients, nurses, and organizations. However, there were limited studies concerning the changes in the practice environment since the COVID-19 pandemic and the way to improve it from nurses' perspectives.Methods: A cross-sectional study was conducted among 460 nurses from seven hospitals in Sichuan, China. Both the quantitative and qualitative data were collected from an online questionnaire. The quantitative data were collected using the Chinese version of the Practice Environment Scale-Nursing Work Index and compared with available norms in 2010. The qualitative data were collected through an open question following the scale and analyzed by content analysis.Results: The mean of the score of the practice environment scale was 3.44 (SD = 0.56) out of 4.00. The score of the total scale and the dimensions were significantly higher than the norms, apart from nurse-physician relations and nurse participation in hospital affairs. The qualitative findings revealed positive changes in nursing foundations for quality of care, nurse participation in hospital affairs and nurse-physician relations, and poor staffing and resource adequacy. The improvement in the working model and ward environment is the primary concern of nurses.Conclusions: The COVID-19 pandemic brought some positive changes in the nursing practice environment, but more efforts are needed to solve those nagging and important problems, such as staff shortages and low participation. Nursing managers and hospital leaders were encouraged to listen to nurses' concerns and value this suitable opportunity for changing and improving to achieve better health services and coping ability to deal with emergency events going forward. Improving the ward environment and taking a professional model instead of sticking to the tedious process might be worthwhile. [ABSTRACT FROM AUTHOR]

Background: Little is known about the gender characteristics and the Corona Virus Disease 2019 (COVID-19) impact on psychiatric department outpatients in general hospitals in China. Methods: We retrospectively collected 225,947 outpatient clinic records before and during COVID-19 pandemic from January 1, 2019 to December 31, 2020 in the psychiatric clinic of 3 general hospitals, gender composition of patients was analyzed in different five age groups and nine diagnostic categories at three levels: total patient visits, number of patients and number of first-visit patients. Results: The total male-to-female ratio of psychiatric outpatient records in 3 general hospitals from 2019 to 2020 was 1:1.69. Women were more common in all age groups. Overall, the proportion of women was further increased in 2020 compared to that in 2019, especially in age group below 34 years and anxiety disorders category. Most mental disorders showed higher demands for females than that for males except mental and behavioral disorders due to psychoactive substance use with the male-to-female ratio was 1:0.05. Conclusions: The demand for female psychiatric outpatient services is obviously higher than that for males. It is necessary to pay more attention to explore targeted mechanism or psychosocial service strategy for female patients with mental disorders. Trial registration ChiCTR2100044894, March 31, 2021 retrospectively registered. [ABSTRACT FROM AUTHOR]

Background: With the increasing incidence of asymptomatic carriers or milder symptoms, children and adolescents are likely to become a silent source of infection. In view of the efficacy and safety of vaccines in the treatment of novel Coronavirus pneumonia, population-wide vaccination will be an inevitable trend to control the spread of COVID-19. However, there is no survey on the attitudes of Chinese parents of children and adolescents towards their children's COVID-19 vaccination. Methods: We used online questionnaires to find out the attitudes of Chinese parents toward their children's immunization against COVID-19. Logistic regression was used to explore the influencing factors. Results: A total of 2019 parents participated in the survey. Overall, 74.38% parents said they would actively get vaccinated, 8.90% refused to get vaccinated, 4.60% said they would delay vaccination and 12.12% were still undecided. Conclusions: In general, Chinese parents have a high desire to be vaccinated against COVID-19, and most parents have a positive attitude towards their children's vaccination. However, many people still hesitate or even refuse to be vaccinated. Education background, attitudes towards children's vaccination, children's age, recent illness and other factors have a certain impact on Chinese parents of children and adolescents towards their children's COVID-19 vaccination. [ABSTRACT FROM AUTHOR]

Background: High incidence of deep vein thrombosis (DVT) has been observed in patients with acute respiratory distress syndrome (ARDS) caused by COVID-19 and those by bacterial pneumonia. However, the differences of incidence and risk factors of DVT in these two groups of ARDS had not been reported before. Study design and methods: We performed a retrospective cohort study to investigate the difference of DVT in incidence and risk factors between the two independent cohorts of ARDS and eventually enrolled 240 patients, 105 of whom with ARDS caused by COVID-19 and 135 caused by bacterial pneumonia. Lower extremity venous compression ultrasound scanning was performed whenever possible regardless of clinical symptoms in the lower limbs. Clinical characteristics, including demographic information, clinical history, vital signs, laboratory findings, treatments, complications, and outcomes, were analyzed for patients with and without DVT in these two cohorts. Results: The 28-days incidence of DVT was higher in patients with COVID-19 than in those with bacterial pneumonia (57.1% vs 41.5%, P = 0.016). Taking death as a competitive risk, the Fine-Gray test showed no significant difference in the 28-day cumulative incidence of DVT between these two groups (P = 0.220). Fine-Gray competing risk analysis also showed an association between increased CK (creatine kinase isoenzyme)-MB levels (P = 0.003), decreased PaO2 (partial pressure of arterial oxygen)/FiO2 (fraction of inspired oxygen) ratios (P = 0.081), increased D-dimer levels (P = 0.064) and increased incidence of DVT in COVID-19 cohort, and an association between invasive mechanical ventilation (IMV; P = 0.001) and higher incidence of DVT and an association between VTE prophylaxis (P = 0.007) and lower incidence of DVT in bacterial pneumonia cohort. The sensitivity and specificity of the corresponding receiver operating characteristic curve originating from the combination of CK-MB levels, PaO2/FiO2 ratios, and D-dimer levels ≥0.5 μg/mL were higher than that of the DVT Wells score (P = 0.020) and were not inferior to that of the Padua prediction score (P = 0.363) for assessing the risk of DVT in COVID-19 cohort. Conclusions: The incidence of DVT in patients with ARDS caused by COVID-19 is higher than those caused by bacterial pneumonia. Furthermore, the risk factors for DVT are completely different between these two ARDS cohorts. It is suggested that COVID-19 is probably an additional risk factor for DVT in ARDS patients. [ABSTRACT FROM AUTHOR]

Background: The Hakka are a subgroup of the Han Chinese, originally from northern China and mainly living in southern China now. Over hundreds of years, the Hakka have developed their own medical practices to prevent and cure diseases, such as medicinal soup, an important characteristic of Hakka cuisine. This study aims at documenting plant taxa used to make Hakka medicinal soup, along with their associated ethnomedical knowledge. Methods: Data on Hakka soup-making plants were collected through key-informant interviews, semi-structured interviews, participatory field collection, and direct observation. The choosing of participants has followed the snowball sampling method. Herbs used for preparing medicinal soup were purchased on the local market or collected from the wild, and voucher specimens were collected and identified. The study result was also compared with published studies on soup-making plants in other parts of Guangdong province and the Hakka areas in Fujian Province of China. Results: Eighty-three taxa belonging to 70 genera within 38 families were listed by our informants as being used to treat 55 kinds of health problems. Most documented plants are herbaceous species, followed by shrubs and woody liana. Roots were the most frequently used plant parts for medicinal purposes, followed, in descending order, by the whole plant, rhizomes, and flowers. Most plants used to prepare medicinal soup are wild-harvested (56 species), 4 cultivated, and 23 wild harvested or cultivated. According to the comparison, 18 Hakka medicinal soup species are shown both in Fujian Province and Guangdong Province. The Hakka soup-making plants in both provinces share very similar therapeutic functions. This study helps to extend the Hakka menu in both provinces. The study comparison also showed a big difference in the herb ingredients between Guangdong Hakka medicinal soup and Cantonese slow-cooked soup. Conclusion: Hakka medicinal soup is an important feature of the Hakka dietary culture. More studies are needed to be undertaken, especially on the efficacy and safety of this medicinal soup. Moreover, cultivation and conservation efforts are required to ensure the sustainability of the species that are used as ingredients in the soup. Consequently, further commercial development of medicinal soup should be promoted. [ABSTRACT FROM AUTHOR]

Objective: To provide experience for formulating prevention and control policies, this study analyzed the effectiveness of the Coronavirus disease 2019(COVID-19) prevention and control policies, and evaluated health equity and epidemic cooperation among BRICS countries. Methods: This study summarized the pandemic prevention and control policies in BRICS countries and evaluated the effectiveness of those policies by extracting COVID-19 related data from official websites. Result: As of May 4, 2021, responding to COVID-19. China adopted containment strategies. China's total confirmed cases (102,560) were stable, without a second pandemic peak, and the total deaths per million (3.37) were much lower than others. India and South Africa who adopted intermediate strategies have similar pandemic curves, total confirmed cases in India (20,664,979) surpassed South Africa (1,586,148) as the highest in five countries, but total deaths per million (163.90) lower than South Africa (919.11). Brazil and Russia adopted mitigation strategies. Total confirmed cases in Brazil (14,856,888) and Russia (4,784,497) continued to increase, and Brazil's total deaths per million (1,936.34) is higher than Russia (751.50) and other countries. Conclusion: This study shows BRICS countries implemented different epidemic interventions. Containment strategy is more effective than intermediate strategy and mitigation strategy in limiting the spread of COVID-19. Especially when a strict containment strategy is implemented in an early stage, but premature relaxation of restrictions may lead to rebounding. It is a good choice to combat COVID-19 by improving the inclusiveness of intervention policies, deepening BRICS epidemic cooperation, and increasing health equities. [ABSTRACT FROM AUTHOR]

Background: Nurses play critical roles when providing health care in high-risk situations, such as during the COVID-19 outbreak. However, no previous study had systematically assessed nurses' mental workloads and its interaction patterns with fatigue, work engagement and COVID-19 exposure risk. Methods: A cross-sectional study was conducted via online questionnaire. The NASA Task Load Index, Fatigue Scale-14, and Utrecht Work Engagement Scale were used to assess nurses' mental workload, fatigue and work engagement, respectively. A total of 1337 valid questionnaires were received and analyzed. Nurses were categorized into different subgroups of mental workload via latent class analysis (LCA). Cross-sectional comparisons, analysis of covariance (ANCOVA), and multivariate (or logistic) regression were subsequently performed to examine how demographic variables, fatigue and work engagement differ among nurses belonging to different subgroups. Results: Three latent classes were identified based on the responses to mental workload assessment: Class 1 – low workload perception & high self-evaluation group (n = 41, 3.1%); Class 2 – medium workload perception & medium self-evaluation group (n = 455, 34.0%); and Class 3 – high workload perception & low self-evaluation group (n = 841, '62.9%). Nurses belonging into class 3 were most likely to be older and have longer professional years, and displayed higher scores of fatigue and work engagement compared with the other latent classes (p < 0.05). Multivariate analysis showed that high cognitive workload increased subjective fatigue, and mental workload may be positively associated with work engagement. Group comparison results indicated that COVID-19 exposure contributed to significantly higher mental workload levels. Conclusions: The complex scenario for the care of patients with infectious diseases, especially during an epidemic, raises the need for improved consideration of nurses' perceived workload, as well as their physical fatigue, work engagement and personal safety when working in public health emergencies. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease (COVID-19) pandemic has had a massive impact on individuals globally. The Chinese government has formulated effective response measures, and medical personnel have been actively responding to challenges associated with the epidemic prevention and control strategies. This study aimed to evaluate the effect of the implementation of a care transition pathway on patients that underwent joint replacement during the COVID-19 pandemic. Methods: A quasi-experimental study was designed to evaluate the effect of implementing a care transition pathway for patients who underwent joint replacement during the COVID-19 pandemic in the orthopedic department of a tertiary care hospital in Beijing, China. Using a convenient sampling method, a total of 96 patients were selected. Of these, 51 patients who had undergone joint replacement in 2019 and received treatment via the routine nursing path were included in the control group. The remaining 45 patients who underwent joint replacement during the COVID-19 epidemic in 2020 and received therapy via the care transition pathway due to the implementation of epidemic prevention and control measures were included in the observation group. The quality of care transition was assessed by the Care Transition Measure (CTM), and patients were followed up 1 week after discharge. Results: The observation group was determined to have better general self-care preparation, written planning materials, doctor-patient communication, health monitoring, and quality of care transition than the control group. Conclusions: A care transition pathway was developed to provide patients with care while transitioning through periods of treatment. It improved the patient perceptions of nursing quality. The COVID-19 pandemic is a huge challenge for health professionals, but we have the ability to improve features of workflows to provide the best possible patient care. [ABSTRACT FROM AUTHOR]

Aims: Hyperuricemia has attracted increasing attention. However, limited concern has been paid to the potential dangers of lowering serum uric acid (SUA). We observed lower levels of SUA in patients with COVID-19. Therefore, we aim to explore whether patients with COVID-19 had SUA lower than normal and the relationship of SUA and the severity of COVID-19. Methods: This was a case–control study based on 91 cases with COVID-19 and 273 age- and sex-matched healthy control subjects. We first compared SUA levels and uric acid/creatinine (UA/Cr) ratio between patients with COVID-19 and the healthy controls. Then, we examined the association of SUA levels and UA/Cr ratios with COVID-19 severity in COVID-19 cases only, defined according to the fifth edition of China's Diagnosis and Treatment Guidelines of COVID-19. Results: SUA levels in patients with COVID-19 were 2.59% lower, UA/Cr ratios 6.06% lower at admission compared with healthy controls. In sex stratified analysis, levels of SUA and UA/Cr were lower in male patients with COVID-19 while only level of SUA was lower in female patients with COVID-19. Moreover, SUA and UA/Cr values were 4.27 and 8.23% lower in the severe group than that in the moderate group among male COVID-19 patients. Bivariate and partial correlations analysis showed negative correlations between SUA or UA/Cr ratio and COVID-19 after adjusting for age, sex, BMI and eGFR. A multiple linear regression analysis showed that SARS-CoV-2 infection and male sex were independent risk factors associated with lower SUA levels. Male patients with COVID-19 accompanied by low SUA levels had higher risk of developing severe symptoms than those with high SUA levels (incidence rate ratio: 4.05; 95% CI:1.11, 14.72) at admission. Comparing SUA and UA/Cr ratio at three time points (admission, discharge, and follow-up), we found that male patients experienced severe symptoms had lower SUA and UA/Cr ratio levels comparing to moderate patients, but no significant difference between three time points. On the contrary, female patients had lower SUA and UA/Cr ratio at discharge than those at admission, but no significant difference of SUA and UA/Cr ratio between moderate and severe group. Conclusion: Patients with COVID-19 had SUA and UA/Cr values lower than normal at admission. Male COVID-19 patients with low SUA levels had a significantly higher crude risk of developing severe symptoms than those with high SUA levels. During disease aggravation, the level of SUA gradually decreased until discharge. At the follow-up exam, the level of SUA was similar to the levels at admission. [ABSTRACT FROM AUTHOR]

Background: Partial- or full-lockdowns, among other interventions during the COVID-19 pandemic, may disproportionally affect people (their behaviors and health outcomes) with lower socioeconomic status (SES). This study examines income-related health inequalities and their main contributors in China during the pandemic. Methods: The 2020 China COVID-19 Survey is an anonymous 74-item survey administered via social media in China. A national sample of 10,545 adults in all 31 provinces, municipalities, and autonomous regions in mainland China provided comprehensive data on sociodemographic characteristics, awareness and attitudes towards COVID-19, lifestyle factors, and health outcomes during the lockdown. Of them, 8448 subjects provided data for this analysis. Concentration Index (CI) and Corrected CI (CCI) were used to measure income-related inequalities in mental health and self-reported health (SRH), respectively. Wagstaff-type decomposition analysis was used to identify contributors to health inequalities. Results: Most participants reported their health status as "very good" (39.0%) or "excellent" (42.3%). CCI of SRH and mental health were − 0.09 (p < 0.01) and 0.04 (p < 0.01), respectively, indicating pro-poor inequality in ill SRH and pro-rich inequality in ill mental health. Income was the leading contributor to inequalities in SRH and mental health, accounting for 62.7% (p < 0.01) and 39.0% (p < 0.05) of income-related inequalities, respectively. The COVID-19 related variables, including self-reported family-member COVID-19 infection, job loss, experiences of food and medication shortage, engagement in physical activity, and five different-level pandemic regions of residence, explained substantial inequalities in ill SRH and ill mental health, accounting for 29.7% (p < 0.01) and 20.6% (p < 0.01), respectively. Self-reported family member COVID-19 infection, experiencing food and medication shortage, and engagement in physical activity explain 9.4% (p < 0.01), 2.6% (the summed contributions of experiencing food shortage (0.9%) and medication shortage (1.7%), p < 0.01), and 17.6% (p < 0.01) inequality in SRH, respectively (8.9% (p < 0.01), 24.1% (p < 0.01), and 15.1% (p < 0.01) for mental health). Conclusions: Per capita household income last year, experiences of food and medication shortage, self-reported family member COVID-19 infection, and physical activity are important contributors to health inequalities, especially mental health in China during the COVID-19 pandemic. Intervention programs should be implemented to support vulnerable groups. [ABSTRACT FROM AUTHOR]

Background: A large number of cases of pneumonia caused by novel β-coronavirus emerged in Hubei Province, China, at the end of 2019 and demonstrated great potential for transmission. At present, known independent risk factors include age, diabetes, and other chronic diseases, which may be similar to the patients with chronic wound; thus, we try to explore the clinical characteristics, prognostic factors, and management recommendation of patients with chronic infective wounds during the COVID-19 epidemic period. Methods: In this single-center, retrospective observational study, we included all cases with chronic infective wounds that came to our hospital between the full outbreak of the COVID-19 in China (January 23, 2020) and the latest date prior to posting (20 April 2020). Demographic data, comorbidities, laboratory and imaging findings, consultation history, and clinical outcomes (lesion cured, uncontrolled, amputated, etc. as of May 10, 2020) were collected for all individuals. Patients were subdivided into gangrene, traumatic infection, and other types of soft tissue infection wound (including bedsores, gout ruptures, stab wounds, and so on) according to the causes of wound, and their disease-related information were compared group by group. Results: Among the total 81 patients with chronic infective wounds, 60% were male, with a mean age of 60.8 years (SD 18.6), including 38 (47%) patients with traumatic infection, 29 (36%) gangrene cases, and 14 (17%) other soft tissue infection wounds. Common comorbidities are hypertension (32%), diabetes (32%), cardiovascular disease (24%), and kidney injury (12%), and the patients with gangrenes have the most comorbidities. As of May 10, 2020, there were 78 patients discharged, and their average stay time is 15.8 days (SD 14.2), while people still at the hospital is 39.7 days (SD 8.7) much longer than the discharged and also has more comorbidities. But there is no significant difference in the hospitalization time of three types of wounds. And fortunately, none of all the patients were infected by coronavirus. Conclusion: The majority of patients with chronic wounds are severely ill with high risk of infection and poor prognosis; therefore, management of patients with chronic wounds should be improved. [ABSTRACT FROM AUTHOR]

Background: The outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China has been declared a public health emergency of international concern. The cardiac injury is a common condition among the hospitalized patients with COVID-19. However, whether N terminal pro B type natriuretic peptide (NT-proBNP) predicted outcome of severe COVID-19 patients was unknown.Methods: The study initially enrolled 102 patients with severe COVID-19 from a continuous sample. After screening out the ineligible cases, 54 patients were analyzed in this study. The primary outcome was in-hospital death defined as the case fatality rate. Research information and following-up data were obtained from their medical records.Results: The best cut-off value of NT-proBNP for predicting in-hospital death was 88.64 pg/mL with the sensitivity for 100% and the specificity for 66.67%. Patients with high NT-proBNP values (> 88.64 pg/mL) had a significantly increased risk of death during the days of following-up compared with those with low values (≤88.64 pg/mL). After adjustment for potential risk factors, NT-proBNP was independently correlated with in-hospital death.Conclusion: NT-proBNP might be an independent risk factor for in-hospital death in patients with severe COVID-19.Trial Registration: ClinicalTrials, NCT04292964. Registered 03 March 2020. [ABSTRACT FROM AUTHOR]

Background: Dental staff were characterized with the tolerance of enduring stress and they are at a high risk to respiratory infectious disease. This study compared the anxiety level of the frontline dental staff (FDS) to the general public in Yichang during the coronavirus disease of 2019 (COVID-19) pandemic and examined potential explanatory factors to the differences. Methods: Two online questionnaires were used separately to collect data from FDS and the general public. The Chinese version of Beck Anxiety Inventory (BAI) was included for the assessment of anxiety. Firstly, a Chi-square test was conducted to compare the anxiety state between these two groups. Then, a bivariate analysis using Cramer's V and Eta squared was conducted to find the potential factors. Lastly, a binary logistic regression was performed to examine the association between potential factors and the anxiety state of FDS. Results: In general, FDS were 4.342 (95% CI: 2.427–7.768) times more likely to suffer from anxiety disorders than the general public. The bivariate analysis showed that age, Level Three Protective Measures (PM-3), conflicts with patients and/or colleagues were moderately associated with the anxiety state of FDS. But the knowledge of COVID-19, the treatment to suspected or confirmed cases both had a weak association with the anxiety among FDS. Conversely, workload, the exposure to potential infectious substance and conducting aerosol generated performance were not significantly related to the anxiety of FDS. As the model indicated, an elder age and PM-3 protective measures could lower the anxiety state of FDS, whereas the conflict with patients or/and colleagues would worsen it. Conclusions: During the COVID-19 pandemic, FDS were more likely to suffer from anxiety disorders than the general public. An elder age, sufficient personal protective measures and good relationships with colleagues and patients would help them to maintain good mental health. [ABSTRACT FROM AUTHOR]

Background: The aim of this study was to quantify the impact of coronavirus disease 2019 (COVID-19) on pediatric operations, and establish preoperative, intraoperative, and postoperative protocols to improve the pediatric operations. Methods: We here compare the number of patients who underwent surgery in Chongqing Medical University Affiliated Children's Hospital during the pandemic (January 23–March 11), after the pandemic (March 12–April 30), after our measures were put in place (May 1–May 21), and the equivalent period in 2019. Result: During the COVID-19 pandemic, 62.68% fewer patients underwent surgery than during the homologous period of time 1 year earlier (P < 0.01). After the COVID-19 pandemic, the number of orchidopexy cases increased significantly from 175.14 to 504.57 per week (P < 0.01). The large number of patients that accrued in our hospital may have increased the risk of COVID-19 transmission. In response, hospitals and clinics have made protocols and reorganized healthcare facilities (e.g., performing nucleic acid tests (NAT), adding adequate personal protective equipment (PPE)) from May 1, 2020. After the measures were implemented, the number of operations performed remained stable and comparable to the pre-pandemic period. COVID-19 RNA detection was performed in 5104 cases and there were no new confirmed cases in our hospital. Conclusion: This outbreak of COVID-19 has affected not only individuals with COVID-19 but also patients seeking surgical operations. Understanding the present situation helps clinicians provide a high level of treatment to all children. [ABSTRACT FROM AUTHOR]