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BACKGROUND : Following the short-term outbreak of coronavirus disease 2019 (COVID-19) in December 2022 in China, clinical data on kidney transplant recipients (KTRs) with COVID-19 are lacking. METHODS : We conducted a single-center retrospective study to describe the clinical features, complications, and mortality rates of hospitalized KTRs infected with COVID-19 between Dec. 16, 2022 and Jan. 31, 2023. The patients were followed up until Mar. 31, 2023. RESULTS : A total of 324 KTRs with COVID-19 were included. The median age was 49 years. The median time between the onset of symptoms and admission was 13 d. Molnupiravir, azvudine, and nirmatrelvir/ritonavir were administered to 67 (20.7%), 11 (3.4%), and 148 (45.7%) patients, respectively. Twenty-nine (9.0%) patients were treated with more than one antiviral agent. Forty-eight (14.8%) patients were treated with tocilizumab and 53 (16.4%) patients received baricitinib therapy. The acute kidney injury (AKI) occurred in 81 (25.0%) patients and 39 (12.0%) patients were admitted to intensive care units. Fungal infections were observed in 55 (17.0%) patients. Fifty (15.4%) patients lost their graft. The 28-d mortality rate of patients was 9.0% and 42 (13.0%) patients died by the end of follow-up. Multivariate Cox regression analysis identified that cerebrovascular disease, AKI incidence, interleukin (IL)‍-6 level of >6.8 pg/mL, daily dose of corticosteroids of >50 mg, and fungal infection were all associated with an increased risk of death for hospitalized patients. CONCLUSIONS : Our findings demonstrate that hospitalized KTRs with COVID-19 are at high risk of mortality. The administration of immunomodulators or the late application of antiviral drugs does not improve patient survival, while higher doses of corticosteroids may increase the death risk.

Although COVID-19 no longer constitutes a "public health emergency of international concern", which still has being spreading around the world at a low level. Small molecule drugs are the main antiviral treatment for novel coronavirus recommended in China. Although a variety of small-molecule antiviral drugs against COVID-19 have been listed in China, there is no specific drug recommendation for special populations. Society of Bacterial Infection and Resistance of Chinese Medical Association, together with the National Clinical Research Center for Respiratory Disease, and the National Center for Respiratory Medicine, organized domestic experts in various fields such as respiratory, virology, infection, critical care, emergency medicine and pharmacy to release Expert Consensus on the Clinical Application of Oral Small-Molecule Antiviral Drugs against COVID-19. The main content of this consensus includes the introduction of seven small-molecule antiviral drugs against COVID-19, focusing on the drug recommendations for 14 special groups such as the elderly, patients with complicated chronic diseases, tumor patients, pregnant women, and children, and providing suggestions for clinicians to standardize drug use.

During the coronavirus disease 2019 (COVID-19) pandemic, vaccines help control the spread of infection. To date, 47 vaccines have been approved, with another 227 candidates in various stages of development. In the short period of time since the beginning of their use, evidence has begun to emerge of complications following vaccination in the form of the development or exacerbation of a number of pathological conditions (Block et al., 2022; Haseeb et al., 2022). For example, a population-based study in France identified 1612 cases of myocarditis and 1613 cases of pericarditis requiring hospital treatment within five months of vaccination (le Vu et al., 2022).

The incidence and mortality of COVID-19 associated pulmonary aspergillosis (CAPA) are high in critically ill patients. Although COVID-19 associated mucormycosis (CAPM) is relatively rare, its severity and often a delayed diagnosis or misdiagnosis lead to its high mortality. The diagnosis and treatment of CAPA and CAPM in critically ill patients are challenging. Early diagnosis and a standardized therapy are the two most important factors for a good outcome. Therefore, a working group of experts from Chinese Thoracic Society and Chinese Association of Chest Physicians Critical Care Group was organized to develop this consensus based on the current medical evidence and clinical practice, in order to improve the ability of clinical treatment for critically ill patients with CAPA and CAPM. The working group drafted a preliminary text based on the literature and clinical practice experience. Following two rounds of discussion, 16 final recommendations were made, with the recommendation strength divided into recommend, suggest and not recommend. -Utilization of chest images and bronchoscopy 1. Chest CT, rather than chest X-ray, is recommended for possible CAPA or CAPM patients to provide diagnostic evidence and localization for bronchoscopy to obtain microbiological specimens. A diagnosis of CAPA could not be made on the basis of positive signs on chest CT alone. Chest contrast CT or pulmonary artery CT (CTPA) is recommended in patients with probable CAPM.2. In the case of possible CAPA or CAPM, it is recommended that bronchoscopy and BALF collection for microbiological examinations be pereformed as soon as possible. -The selection strategies of microbiological examinations 3. Microscopic examination, culture, GM testing and PCR for aspergillus Spp . of BALF are recommended in patients with probable CAPA. Fungal staining and culture of BALF are suggested for possible CAPM. Selected appropriate specimens for molecular biological detection are suggested in critically ill patients and possible CAPM. -Diagnostic critieria 4. The revised ECMM/ISHAM consensus statement is recommended as the diagnostic criteria for CAPA and the Delphi consensus statement is recommended as the diagnostic criteria for CAPM. -Appropriate time for antifungal therapy 5. Prophylactic therapy of CAPA with amphotericin B or its liposomes is suggested for patients with severe COVID-19, especially those with risk factors for CAPA.6. It is recommended to start the empirical anti-Aspergillus therapy as soon as possible for possible CAPA, and obtain the microbiological evidence for aspergillosis at the same time.7. Prophylactic therapy for CAPM is not recommended for severe COVID-19 patients.8. Early initiation of empirical therapy for possible CAPM is recommended, and microbiological evidence should be obtained at the same time. -Clinical applications for antifungal agents 9.Voriconazole or isavuconazole are recommended as initial treatment for CAPA. Amphotericin B liposomes are suggested as the initial treatment for CAPM. Isavuconazole or posaconazole may be an option in patients with renal insufficiency or amphotericin B liposome intolerance/unavailability.10. In CAPA patients with tracheobronchitis, antifungal drug inhalation is recommended in addition to systemic antifungal medication.11. Combination therapy is not recommended as initial therapy for CAPA, but may be used as a salvage therapy strategy. Triazole or amphotericin B in combination with caspofungin or micafungin is recommended; whereas amphotericin B in combination with triazole is not recommended. For CAPM patients with extensive lesions, rapid progression or poor general condition, a combination of amphotericin B liposome with isavuconazole or posaconazole is suggested. -Response assessment and treatment duration 12. It is recommended that treatment response be assessed comprehensively according to the clinical symptoms/signs, imaging and microbiological examination of patients. CAPA can be evaluated in combination with the dynamic change in serum GM.13. The recommended treatment duration of CAPA is at least 6-12 weeks. A total course of at least 3-6 months is suggested for CAPM, and the sequential treatment should be considered according to the response to 4-6 weeks of intravenous therapy. -How to adjust the anti-inflammatory therapy 14. In patients with severe COVID-19 combined with possible or probable filamentous fungal infection, it is suggested that of anti-inflammatory therapy be stopped or reduced appropriately, taking into account of the severity of the infection and inflammation of the disease course. The combination of baritinib and/or tozzizumab based on glucocorticoids is not suggested in these patients. -How to treat the underlying diseases 15. In patients with diabetes, strict glycaemic control is suggested. In patients with long-term use of glucocorticoids and/or immunosuppressants, it is suggested to reduce the intensity of immunosuppression. Granulocyte colony-stimulating factor is suggested to use to improve the circulating granulocyte levels in patients with granulocyte deficiency due to various causes. -When an operation should be considered 16. In patients with CAPA, surgery is not recommended unless large blood vessels, pericardium, or chest wall are involved, or the patient has recurrent or massive hemoptysis. For CAPM patients, early surgical removal of lesions after diagnosis is recommended. Surgery is a high-risk procedure in patients with severe COVID-19, and a multidisciplinary team discuss is suggested.

During the COVID-19 pandemic, a series of non-pharmaceutical interventions, which were implemented to curb the spread of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), significantly modified the seasonal pattern of influenza. The intensity of influenza activity markedly decreased and B/Yamagata lineage was no longer detected. As the national influenza sentinel surveillance data shown, clear seasonal patterns were observed for influenza between 2012-2019, annually with an average of 14.57% of specimens tested positive for influenza virus. However, the seasonal pattern of influenza was disrupted after the outbreak of COVID-19. In the 2020-2021 season, influenza demonstrated an extremely low activity (yearly positivity rate<1.0%), followed by a resurgence of winter peak in the 2021-2022 season. Following the downgrade of management of COVID-19 to Class B in China in December 26, 2022, social activities gradually resumed, leading to the rebound of influenza activity with an out-of-season ciculation. After COVID-19 pademic, other respiratory infectious diseases caused by SARS-CoV-2, respiratory syncytial virus, and mycoplasma pneumonia were alternatively or concurrently circulated with influenza. The prevention and control of influenza and other respiratory infectious diseases emphasizes a multi-disease prevention strategy, including long-term and continuous monitoring the epidemic trends in influenza virus and SARS-CoV-2, promoting influenza and COVID-19 vaccination among key populations, and strengthening the knowledge and public awareness of prevention and control for respiratory infectious diseases, etc.

Objective: To describe the clinical characteristics of SARS-CoV-2 infected patients with interstitial lung abnormalities (ILA) during the COVID-19 pandemic. Methods: We respectively enrolled ILA patients who had been regularly followed up in Peking Union Medical College Hospital for more than six months since January 2021. Clinical data of these ILA patients were collected after the outbreak of COVID-19 pandemic (from December 2022 to January 2023), thirty-eight patients with preexisting ILA were enrolled. Among them, there were 34 ILA patients (20 males and 14 females) who were infected with SARS-CoV-2 during this period, with an average age of (64.0±8.8) years old (range: 41-80). There were 12 (35.3%) ILA patients who were suffered from COVID-19(pneumonia group) and others were the non-pneumonia group. The clinical characteristics, including vaccination status, features of COVID-19 and outcomes of the two groups were compared. Results: Regarding the subcategories of ILA, there were 7 cases of subpleural fibrotic ILA, 10 cases of subpleural non-fibrotic ILA, and 17 cases of non-subpleural ILA. Before SARS-CoV-2 infection, the average pulse oxygen saturation at rest was (97.38±0.87)% (range: 96%-99%); average forced vital capacity (FVC) was (97.6±18.1)% predicted (range: 65%-132%); and average diffusion capacity for carbon monoxide (D L CO) was (76.2±16.3)% predicted (range: 53%-108%). Nineteen patients had been vaccinated with 3 doses of SARS-CoV-2 vaccines, and 5 of them developed COVID-19. One patient had received one dose of vaccine and did not develop COVID-19. The other 14 patients had not been vaccinated, and seven of them developed COVID-19. Of the 12 patients with COVID-19, six were diagnosed with severe COVID-19, and the other 6 ILA patients were diagnosed with moderate COVID-19. Among them, 1 patient was complicated by deep vein thrombosis of left lower limb. All 6 patients with severe COVID-19 who were cured after systemic corticosteroids. As for the other six moderate COVID-19 patients, all were cured and/or improved greatly: two were treated with short-term oral corticosteroids, one was prescribed a dose of compound betamethasone, and the other two were not treated with systemic corticosteroids. Conclusion: Patients with ILA were predisposed to develop COVID-19 after infection with SARS-CoV-2, and more than half of them had severe COVID-19.

Objective: To investigate the clinical features of acute macular neuroretinopathy (AMN) following coronavirus disease 2019 (COVID-19). Methods: This retrospective case series study included 15 patients (28 eyes) diagnosed with AMN at the Department of Ophthalmology, Peking University Third Hospital, from November 2022 to January 2023. The AMN group comprised 4 males and 11 females, with a mean age of (31.36±8.08) years. A control group of 15 individuals [5 males, 10 females; mean age (33.20±5.10) years] who had COVID-19 but did not develop AMN was also included. Data collected for all patients included best-corrected visual acuity (BCVA), slit-lamp examination, dilated fundus examination, color fundus photography, fluorescein fundus angiography (FFA), and optical coherence tomography (OCT) results. Serum cytokine levels, including interleukins (ILs), interferons (IFNs), and tumor necrosis factor-alpha (TNF-α), were measured for both groups. Results: Among the 28 eyes, severe vision loss (BCVA≤0.3) was observed in 3 eyes (10.7%), moderate vision loss (BCVA>0.3 and≤0.5) in 2 eyes (13.3%), and mild vision loss (BCVA>0.5 and≤1.0) in 23 eyes (82.1%). OCT findings in all 28 eyes revealed hyperreflectivity of the outer nuclear layer and disruption of outer retinal structure. Additionally, 3 eyes (10.7%) exhibited cotton wool spots in the posterior pole, 2 eyes (7.1%) showed mild cystoid macular edema with intraretinal hyperreflective dots, and 1 eye (3.6%) presented with paracentral acute middle maculopathy. FFA indicated retinal vasculitis in 2 cases (4 eyes, 14.3%). Serum levels of IL-4, IL-5, IFN-α, and IFN-γ were significantly higher in the AMN group compared to the control group: IL-4 [4.49 (3.66, 6.08) vs . 1.40 (0.62, 1.68) pg/ml], IL-5 [7.34 (5.04, 14.06) vs . 0.17 (0.11, 1.86) pg/ml], IFN-α [8.42 (6.31, 14.89) vs . 0.50 (0.30, 0.83) pg/ml], and IFN-γ [17.93 (12.75, 32.44) vs . 7.43 (0.00, 14.74) pg/ml], with all differences being statistically significant (all P <0.05). Conclusion: AMN following COVID-19 can present with wedge-shaped dark red lesions in the macular area, often accompanied by cotton wool spots and retinal vasculitis. Additionally, there is a significant elevation in various inflammatory cytokines in the serum.

Coronavirus disease 2019(COVID-19) is prevalent around the world, and pre-existing ILD is associated with increased severity and mortality of COVID-19. However, the current knowledge on the management strategy for COVID-19 patients with pre-existing interstitial lung disease (ILD) is very limited. There is still a need for consensus on treatments for these patients. In addition, ILD that occurs after the acute phase of COVID-19 (Post-acute Covid-19 ILD, PC-ILD) is also very common, and how to manage PC-ILD is also under debate. Therefore, a consensus was established by experts from the related disciplines in the field of ILD based on available scientific evidence and experience of the expert working group. This consensus elucidated 22 practical questions for practicing physicians, such as clinical characteristics, risk factors and treatment of COVID-19 patients with pre-existing ILD and PC-ILD patients. Finally, 15 recommendations were made regarding the diagnosis and management of COVID-19 patients with pre-existing ILD and PC-ILD patients. We hope to assist physicians in making appropriate decisions, thereby improving the management of COVID-19 with pre-existing ILD and PC-ILD. Recommendation 1: It is recommended to differentiate COVID-19 from ILD with acute/subacute onset based on duration, exposure history, symptoms and signs, chest high-resolution CT (HRCT) features, and laboratory tests. Recommendation 2: According to the guidelines on the diagnosis and treatment of new coronavirus pneumonia (version 10) issued by the National Health Commission of China on January 6 th , 2023, we recommended the following disease severity definition and management for the COVID-19 patients with pre-existing ILD. Recommendation 3: ILD is an independent risk factor for severe/critical COVID-19. We recommend antiviral treatment for COVID-19 patients with pre-existing ILD as early as possible after symptoms onset, ideally within 5 days. Recommendation 4: We recommend that the use of systemic corticosteroids in COVID-19 patients with pre-existing ILD who had no indications for corticosteroids therapy should follow the guidelines of COVID-19 for the general population. Those with pre-existing ILD who need to start or are already on systemic corticosteroids are recommended to start or continue corticosteroids if they develop COVID-19. The dose adjustment is based on the severity of COVID-19 with pre-existing ILD: For the patients with severe/critical COVID-19 with pre-existing ILD but no AE-ILD, the use of corticosteroids should follow the guidelines of COVID-19 in the general population; the patients with AE-ILD are recommended to follow the use of corticosteroids in AE-ILD. Recommendation 5: There is no evidence available for the use of interleukin-6 receptor blockers in COVID-19 patients with pre-existing ILD. Recommendations regarding interleukin-6 receptor blockers in COVID-19 patients with pre-existing ILD may follow the guideline of COVID-19 in the general population. Recommendation 6: There is no evidence to support the use of Janus kinase inhibitors in COVID-19 patients with pre-existing ILD. The use of Janus kinase inhibitors in COVID-19 patients with pre-existing ILD is recommended to follow the guideline of COVID-19 in the general population. Recommendation 7: For patients who have not started immunosuppressants/biological agents for pre-existing ILD at the time of COVID-19, delayed initiation of immunosuppressants/biological agents is recommended, if the risk of ILD progression in the short term is low. For patients who are already on immunosuppressants/biological agents, a multidisciplinary discussion with rheumatologists is recommended to weigh the benefits and risks of discontinuing immunosuppressants/biological agents. It is recommended to discontinue immunosuppressants/biological agents for pre-existing ILD in acute phase of COVID-19 unless short-term discontinuation affects control of underlying ILD or connective tissue disease. Recommendation 8: It is recommended that the COVID-19 patients with pre-existing ILD who are on anti-fibrotic medication should continue to take anti-fibrotic medication. For COVID-19 patients with newly diagnosed fibrotic ILD who need to start anti-fibrotic therapy, it is recommended to start anti-fibrotic treatment as early as possible. Recommendation 9: It is recommended to investigate and monitor co-infections and secondary infections in COVID-19 patients with pre-existing ILD, and to promptly prevent and treat co-infections and secondary infections such as bacteria, fungi, Pneumocystis jirovecii , and cytomegalovirus. Recommendation 10: Anticoagulation therapy for the COVID-19 patients with pre-existing ILD is recommended to be used in accordance with guideline of COVID-19 in general population. Recommendation 11: For COVID-19 patients with pre-existing ILD, we recommend follow-up at 4 weeks after recovery (non-hospitalized patients) or 4 weeks after discharge (hospitalized patients), and then the routine monitoring frequency for ILD once stable, i.e . every 3 to 6 months. Pulmonary function testing is a routine investigation. Chest HRCT is suggested when clinically indicated. Arterial blood gas analysis, echocardiography, CT pulmonary angiography, and blood examinations can be selected when necessary. Recommendation 12: Severe/critical COVID-19 survivors are the main target population for rehabilitation intervention. Rehabilitation therapy should be administered individualized. Recommendation 13: Healthcare providers should fully inform patients with pre-existing ILD about the benefits and risks of vaccination, and involve patients in a shared decision-making process to discuss whether or not to receive a COVID-19 vaccine. Recommendation 14: For PC-ILD patients with persistent or progressive respiratory symptoms, persistent interstitial lung abnormalities and lung function impairment following acute COVID-19 pneumonia, may be treated with glucocorticoids after exclusion of other causes such as infection. Recommendation 15: For PC-ILD patients who have recovered from severe/critical COVID-19, anti-fibrotic medications may be administered after discussing disease-and treatment-related factors with patients. The optimal timing and duration of anti-fibrotic treatment are still uncertain. We conditionally recommend against anti-fibrotic medications in patients who have recovered from mild or moderate COVID-19. This recommendation does not apply to patients with pre-existing fibrotic ILD.

COVID-19 is caused by the infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and manifests primarily as acute lung injury with diffuse interstitial lung disease evident in imaging. Patients often present with clinical features similar to those of autoimmune diseases and share imaging, treatment and serological similarities with autoimmune-related interstitial lung diseases. The association between autoimmune abnormalities and post-COVID-19 pulmonary fibrosis is also recognized. This article provided a comprehensive review of the pathogenic mechanisms, clinical manifestations, and therapeutic interventions associated with autoimmune abnormalities induced by SARS-CoV-2 infection.

The COVID-19 pandemic led to significant burnout among nurses, resulting in a shortage of nursing staff. Issues related to nursing work have received significant attention recently, and only healthy nurses are capable of providing good quality patient care. The authors employed Bronfenbrenner's Ecological System Theory to analyze the impact of the COVID-19 pandemic on nurses and proposed specific strategies and recommendations to enhance the nursing workplace. Under the Ecological System Theory, several factors, including inadequate preparedness, dangerous working environment, work-family conflicts, discrimination due to public panic, and health damage, contribute to nurse burnout. Whether during or after the COVID-19 pandemic, it is necessary to provide education programs to enhance the professional abilities of nurses, foster policies that promote a positive practice work environment, implement a triage system based on the severity of patients, elevate the image of the nursing profession, monitor the health of nurses, and advocate for transformational leadership. The nursing workplace should help nurses gain greater confidence and improve their ability to handle various workplace challenges. In the future, medical institutions should provide a better work environment for nurses and expect the public to pay more attention to the development of the nursing profession.

Objective: To summarize the clinical characteristics of coronavirus disease 2019 (COVID-19) in patients with Good's syndrome. Methods: We included all cases of COVID-19 in patients with Good's syndrome in the Second Xiangya Hospital of Central South University from January 1, 2023 to August 31, 2023. In addition to our cases, we searched the published literature in Wanfang database and PubMed database using the keywords "Good's syndrome" and "COVID-19". The clinical characteristics, treatment and outcome of the patients were summarized and analyzed. Results: A total of four patients with Good's syndrome complicated by COVID-19 were identified in our hospital, all of them were male, and the days of hospitalization were 17, 23, 7, and 13 days, respectively. Databases were searched for a total of six patients with Good's syndrome complicated by COVID-19, including three females and three males, all foreign patients, with hospitalization days of 12, 22, 13, 25, 21, and 34 days respectively. All ten patients met the diagnostic criteria for severe or critical COVID-19, and three(all middle-aged males) of them died, two from sepsis and one from respiratory failure. They were. Conclusion: COVID-19 in patients with Good's syndrome are prone to develop severe or critical disease and are more likely to be infected with multiple pathogens. Timely immunoglobulin supplementation is the key to treatment.

Objective: To analyze the clinical characteristics of hemodialysis patients with corona virus disease 2019 (COVID-19) in a single-center from Beijing., Methods: Patients with COVID-19 who received regular hemodialysis at Peking University Third Hospital from November 30, 2022 to January 4, 2023 were selected as the study objects. Clinical symptoms, severity and duration of symptoms during the period of virus positive were investigated in the form of questionnaires, and the basic information of the patients, as well as the results of blood tests (routine blood and blood biochemistry, etc .) before and after infection, dialysis treatment and the outcome of the disease were collected by consulting medical records., Results: A total of 203 subjects were included in this study, including 148 mild cases (72.91%), 23 medium cases (11.33%), 32 severe and critical cases (15.76%), and 16 (7.88%) deaths occured during the follow-up. Clinical symptoms mainly included respiratory symptoms (among which 81.77% had cough, 68.97% had expectoration), fever (81.28%) and fatigue (65.52%), and fatigue and weakness had the longest duration [9 (5, 15) days] among all symptoms. Twenty-six patients (12.8%) reduced the dialysis sessions [1 (1, 2) times], 25 patients (12.32%) had the behavior of early finishing dialysis (27 times), reducing the dialysis time by 30.0 (20.0, 30.5) minutes. Univa-riate analysis showed that the hemoglobin, creatinine, urea nitrogen and ultrafiltration decreased signi-ficantly after infection ( P < 0.05). There were significant differences in age, albumin, hemoglobin, creatinine levels and vascular access types among the patients with different clinical subtypes, and the changes of dialysis sessions, fever, expectoration and fatigue degree were also different among the patients with different clinical subtypes ( P < 0.05). Multivariate Logistic regression analysis showed that age ( OR =1.051, 95% CI : 1.017-1.086, P =0.003) and albumin levels ( OR =0.905, 95% CI : 0.803-1.019, P =0.098) corrected by fever, expectoration and fatigue levels were still associated with the occurrence of pneumonia., Conclusion: The morbidity of pneumonia and the proportion of deaths in hemodialysis patients with COVID-19 were higher, and some clinical symptoms lasted for a longer time than the general population. During the infection period, the incidence of dialysis-related complications increased, hemoglobin and nutritional status decreased. Elderly patients and patients with low albumin level had a higher risk of developing pneumonia after infection.

Objective: To retrieve, evaluate, and summarize the best evidence for the treatment of hypoxemia in patients with COVID-19 infection using the awake prone positioning, with the aim of guiding healthcare professionals in the standardized implementation of this therapy. Methods: A systematic search was conducted in databases including UpToDate, BMJ Best Practice, JBI Evidence-Based Healthcare Center, American Association of Critical-Care Nurses, Intensive Care Society, European Respiratory Society, World Health Organization website, Cochrane Library, PubMed, China National Knowledge Infrastructure (CNKI), and Wanfang. The retrieved literature was subjected to quality assessment and evidence extraction. Results: A total of ten publications were included, consisting of one thematic evidence summary, one guideline, two systematic reviews, three randomized controlled trials, and three expert consensus statements. This summary synthesizes thirty key pieces of evidence in five categories: organizational management and training, risk assessment, preparatory operations, implementation key points, and risk control. Conclusions: Awake prone positioning is beneficial for improving hypoxemia in patients with COVID-19 and is easy to implement. Medical institutions should develop nursing management systems, operational standards, and best practices for awake prone positioning based on evidence-based evidence in order to improve the quality of care management for such patients.

The corona virus disease 2019(COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2), has created an urgent need of scientific and effective biomarkers for the purpose of prevention and control. Currently, commonly employed viral nucleic acids, antibodies, and rapid antigen test detection technologies all exhibit a range of limitations, including restricted applicability, inadequate sensitivity and specificity. Plasma SARS-CoV-2 quantitative antigen, as an emerging biomarker, has garnered significant attention due to its potential clinical value in the diagnosis and management of COVID-19. This article comprehensively analyzes the principles and clinical applications of quantitative detection technology for plasma SARS-CoV-2 antigen. Additionally, it explores the challenges encountered in this field and provides insights into future prospects.

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Public health and social measures (PHSMs) are one of the most important measures in the prevention and control of COVID-19 and have also been effective in suppressing the spread of influenza viruses, but their effectiveness has not been fully investigated. This study aimed to review the progress of research on the impact of PHSMs on influenza during the COVID-19 pandemic based on the latest evidence of the effectiveness of various PHSMs in controlling transmission of influenza viruses, to provide scientific evidence for optimizing influenza prevention and control strategies.

Ischemic colitis is a disease in which local tissue in the intestinal wall dies to varying degrees due to insufficient blood supply to the colon. Risk factors include cardiovascular disease, diabetes, chronic kidney disease, chronic obstructive pulmonary disease, etc . Typical clinical manifestations of the disease are abdominal pain and hematochezia. The most common locations are the watershed areas of splenic flexure and rectosigmoid junction. The lesions are segmental and clearly demarcated from normal mucosa under endoscopy. The digestive tract is a common extra-pulmonary organ affected by the novel coronavirus, which can be directly damaged by the virus or indirectly caused by virus-mediated inflammation and hypercoagulability. The corona virus disease 2019 (COVID-19) associated intestinal injury can be characterized by malabsorption, malnutrition, intestinal flora shift, etc . CT can show intestinal ischemia, intestinal wall thickening, intestinal wall cystoid gas, intestinal obstruction, ascites, intussusception and other signs. In this study, we reported a case of ischemic colitis in a moderate COVID-19 patient. The affected area was atypical and the endoscope showed diffuse lesions from the cecum to the rectosigmoid junction. No signs of intestinal ischemia were found on imaging and clear thrombosis in small interstitial vessels was found in pathological tissue. Combined with the fact that the patient had no special risk factors in his past history, the laboratory tests indicated elevated ferritin and D-dimer, while the autoantibodies and fecal etiology results were negative, we speculated that the hypercoagulability caused by novel coronavirus infection was involved in the occurrence and development of the disease in this patient. After prolonged infusion support and prophylactic anti-infection therapy, the patient slowly resumed diet and eventually went into remission. Finally, we hoped to attract clinical attention with the help of this case of moderate COVID-19 complicated with ischemic colitis which had a wide range of lesions and a slow reco-very. For patients with abdominal pain and blood in the stool after being diagnosed as COVID-19, even if they are not severe COVID-19, they should be alert to the possibility of ischemic colitis, so as not to be mistaken for gastrointestinal reactions related to COVID-19.

Copyright of Tianjin Medical Journal is the property of Tianjin Medical Journal and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background Long COVID is a common problem in the recovery period of coronavirus disease (COVID-19). The prevention and treatment of long COVID has become the focus of the medical fields of COVID-19. It is important to clarify the situation of long COVID in China and find out the follow-up research route, thus providing evidence-based evidence for clinical practice. Objective To explore the characteristics of long COVID in China, aiming to provide references for the follow-up research. Methods From January 2023 to August 2023, a self-made survey questionnaire was used to investigate the current situation of long COVID in China. The questionnaire included general information, such as gender and age, treatment expectations, symptoms and signs in acute and recovery period, etc. Results A total of 1 001 questionnaires were collected, including 901 people infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and 585 (64.9%) people with long COVID. Binary Logistic regression analysis showed that female (OR=2.000, 95%CI=1.477-2.705, P

The outbreak of COVID-19 has had a huge impact globally. After the infection, a considerable number of patients have been affected by a series of lingering symptoms or sequelae with strong heterogeneity, which we temporarily refer to as long COVID. Compared to the well-studied cardiovascular complications caused by COVID-19 during the acute phase, the cardiovascular sequelae in long COVID require greater attention. This review includes the clinical manifestations, mechanisms, and principles of diagnosis and management of cardiovascular sequelae in long COVID, aiming to improve the disease's understanding and reduce its harm scientifically.

The incidence of erectile dysfunction (ED) has been reported to increase after COVID-19 infection, and it is common in COVID-19 patients during recovery. This paper presents a summary of the latest research progress on COVID-19-induced ED and explores the traditional Chinese medicine (TCM) diagnosis and treatment approach based on TCM theory and clinical experience. COVID-19 infection may lead to ED through endothelial dysfunction, testicular injury, hormonal imbalance, and psychological factors. The pathogenesis of COVID-19-related ED is mainly characterized by deficiency of the body's essence and excess of pathogenic factors. In the early stage, it is dominated by deficiency of qi and yin, while in the middle stage, it is mainly due to deficiency of qi and blood stasis. In the long-term, ED is based on the imbalance of yin and yang, with liver stagnation and qi stagnation often co-existing. Clinical manifestations of ED vary, and treatment should focus on tonifying qi and nourishing yin, promoting blood circulation, regulating yin and yang, and soothing liver depression according to TCM diagnosis and treatment principles.

ObjectiveTo study the prevalence of depression, anxiety, and insomnia among social workers during the prolonged battle against the COVID-19 pandemic and explore the associated risk factors.MethodsUsing a stratified cluster sampling method, we selected all social workers in the five streets of Chaoyang District, Beijing(Jiuxianqiao, Wangjing, Taiyanggong, Shibalidian, Sunhe) from November 2021 to March 2022 as the study population(social worker group), and the frontline medical staffs(medical professional group) of the same age range of the corresponding community hospitals of the same five streets, and the community residents(resident group) as the control population. The ratio of the social worker group, medical professional group, and resident group was 1∶1∶1. The Sojump platform was used to send electronic questionnaires to the wechat groups of social workers, healthcare workers, and community residents to carry out the survey. The screen positive rates for anxiety, depression, and sleep disorders were compared among the 3 groups. Multifactorial Logistic regression and decision tree were used to analyze the influencing factors of anxiety, depression, and sleep disorders among social workers.ResultsA total of 954 questionnaires were collected, of which 62 were disqualified and excluded. Finally, 892 valid questionnaires(93.5%) were included for data analysis. Among them, there were 372 questionnaires(41.7%) from the social worker group, 262(29.4%) from the medical professional group, and 258(28.9%) from the resident group. The prevalences of anxiety, depression, and sleep disorders among social workers group were found to be 15.3%, 22.0%, and 48.1%, respectively, which were significantly higher than those in the medical professional group(7.6%, 10.3%, and 30.5%) and the resident group(7.0%, 8.5%, and 29.5%), all P < 0.001. Multiple Logistic regression showed that family burden(OR=1.80, 95% CI: 1.09-2.96) and Chinese perceived stress scale(CPSS) score(OR=1.34, 95% CI: 1.24-1.45) were independent influencing factors for anxiety among social workers; CPSS score(OR=1.29, 95% CI: 1.20-1.39) and social support rating scale(SSRS) score(OR=0.96, 95% CI: 0.92-1.00) were independent influencing factors for depression among social workers; family history of mental illness(OR=4.91, 95% CI: 1.27-18.94), CPSS score(OR=1.20, 95% CI: 1.14-1.27), and SSRS score(OR=0.95, 95% CI: 0.91-0.98) were independent influencing factors for sleep disorders among social workers. The results of decision tree analysis were consistent with those of multiple Logistic regression analysis. Family burden, CPSS score, and SSRS score were important variables affecting the mental health of social workers, among which CPSS score was strongly associated with anxiety, depression, and sleep disorders among social workers.ConclusionsSocial workers exhibited significant levels of anxiety, depression, and sleep disorders during the long-term pandemic prevention, with CPSS being the most significant influencing factor.

The outbreak of coronavirus disease 2019 (COVID-19) has become a major threat to the global healthcare system. As an airborne disease, COVID-19 posed a great challenge to the management of sleep medicine. Given the increased risk of adverse events in obstructive sleep apnea patients infected with COVID-19, strategies have been proposed worldwide. These include standard treatment procedure, use of self-protect equipment, telemedicine services, development of machine learning and portable monitoring, and in-home sleep monitoring and titration. This review aims to introduce the impact of COVID-19 on the operation of sleep medicine landscape and provide advice on public health care emergency.

Objective: To evaluate the immunogenicity, safety, and immune persistence of the sequential booster with the recombinant protein-based COVID-19 vaccine (CHO cell) in healthy people aged 18-84 years. Methods: An open-label, multi-center trial was conducted in October 2021. The eligible healthy individuals, aged 18-84 years who had completed primary immunization with the inactivated COVID-19 vaccine 3 to 9 months before, were recruited from Shangyu district of Shaoxing and Kaihua county of Quzhou, Zhejiang province. All participants were divided into three groups based on the differences in prime-boost intervals: Group A (3-4 months), Group B (5-6 months) and Group C (7-9 months), with 320 persons per group. All participants received the recombinant COVID-19 vaccine (CHO cell). Blood samples were collected before the vaccination and after receiving the booster at 14 days, 30 days, and 180 days for analysis of GMTs, antibody positivity rates, and seroconversion rates. All adverse events were collected within one month and serious adverse events were collected within six months. The incidences of adverse reactions were analyzed after the booster. Results: The age of 960 participants was (52.3±11.5) years old, and 47.4% were males (455). The GMTs of Groups B and C were 65.26 (54.51-78.12) and 60.97 (50.61-73.45) at 14 days after the booster, both higher than Group A's 44.79 (36.94-54.30) ( P value<0.05). The GMTs of Groups B and C were 23.95 (20.18-28.42) and 27.98 (23.45-33.39) at 30 days after the booster, both higher than Group A's 15.71 (13.24-18.63) ( P value <0.05). At 14 days after the booster, the antibody positivity rates in Groups A, B, and C were 91.69% (276/301), 94.38% (302/320), and 93.95% (295/314), respectively. The seroconversion rates in the three groups were 90.37% (272/301), 93.75% (300/320), and 93.31% (293/314), respectively. There was no significant difference among these rates in the three groups (all P values >0.05). At 30 days after the booster, antibody positivity rates in Groups A, B, and C were 79.60% (238/299), 87.74% (279/318), and 90.48% (285/315), respectively. The seroconversion rates in the three groups were 76.92% (230/299), 85.85% (273/318), and 88.25% (278/315), respectively. There was a significant difference among these rates in the three groups (all P values <0.001). During the sequential booster immunization, the incidence of adverse events in 960 participants was 15.31% (147/960), with rates of about 14.38% (46/320), 17.50% (56/320), and 14.06% (45/320) in Groups A, B, and C, respectively. The incidence of adverse reactions was 8.02% (77/960), with rates of about 7.50% (24/320), 6.88% (22/320), and 9.69% (31/320) in Groups A, B, and C, respectively. No serious adverse events related to the booster were reported. Conclusion: Healthy individuals aged 18-84 years, who had completed primary immunization with the inactivated COVID-19 vaccine 3 to 9 months before, have good immunogenicity and safety profiles following the sequential booster with the recombinant COVID-19 vaccine (CHO cell).

Background: COVID-19 affected both the physical and mental health of frontline nurses and the stability of the nursing workforce. Purpose: This study was designed to explore the influence of demographic variables, physical and mental health status, perceived work stress, and job satisfaction on intention to continue working as nurses among nursing staff who had been infected by COVID-19. Method: In this cross-sectional study, an internal online survey was used to collect data from 152 nurses at a hospital in southern Taiwan. The questionnaires in the survey included the Chinese Health Survey Scale, Stress Scale on COVID-19 Patient Care, McCloskey/ Mueller Satisfaction Scale, and Employee Retention Scale. Data analysis was conducted using SPSS/Windows 22.0. Results: The most significant predictors identified included age, seniority, level of education, job satisfaction, physical and mental wellbeing, and work stress. These predictors collectively explained 32% of the total variance in retention willingness (F [18,128] = 4.78, p < .001). Almost half (46.7%; 71/152) of the participants expressed intent to continue working in nursing. Being a senior staff and having a master's degree or higher were positively associated with retention. Conclusions/ Implications for Practice: The findings may be referenced by healthcare organizations and managers to help healthcare staff gain strength and resilience against future pandemics. Key recommendations include reducing staff work stress, increasing job satisfaction, and facilitating a more equitable life-work balance. [ABSTRACT FROM AUTHOR]

In recent years， regional compound air pollution events caused by fine particles （PM 2.5 ） and ozone （O 3 ） have occurred frequently in economically developed areas of China， in which atmospheric oxidizing capacity （AOC） has played an important role. In this study， the WRF-CMAQ model was used to study the impacts of anthropogenic emission reduction on AOC during the COVID-19 lockdown period. Three representative cities in eastern China （Shijiazhuang， Nanjing， and Guangzhou） were selected for an in-depth analysis to quantify the contribution of meteorology and emissions to the changes in AOC and oxidants and to discuss the impact of AOC changes on the formation of secondary pollutants. The results showed that， compared with that in the same period in 2019， the urban average AOC in Shijiazhuang， Nanjing， and Guangzhou in 2020 increased by 60%， 48.7%， and 12.6%， respectively. The concentrations of O 3 ， hydroxyl radical （·OH）， and nitrogen trioxide （NO 3 ·） increased by 1.6%-26.4%， 14.8%-73.3%， and 37.9%-180%， respectively. The AOC in the three cities increased by 0.06×10 -4 ， 0.12×10 -4 ， and 0.33×10 -4 min -1 ， respectively， due to emission reduction. The meteorological change increased AOC in Shijiazhuang and Nanjing by 20% and 17.9%， respectively， but decreased AOC in Guangzhou by -9.3%. Enhanced AOC led to an increase in the nitrogen oxidation ratio （NOR） and VOCs oxidation ratio （VOR） and promoted the transformation of primary pollutants to secondary pollutants. This offset the effects of primary emission reduction and resulted in a nonlinear decline in secondary pollutants compared to emissions during the COVID-19 lockdown.

Background: Patient safety culture is an indicator of healthcare quality and a topic of global importance in medical care., Purpose: In this study, the attitudes towards patient safety culture of nursing staff working in the emergency, intensive care, and general wards are compared before and during the COVID-19 pandemic., Methods: A retrospective research design was utilized and an anonymous questionnaire survey conducted on the Taiwan Patient Safety Culture Survey web-based platform system was used to collect the data. The survey was administered in a regional hospital in northern Taiwan between 2018 and 2020. The 1,540 nursing personnel who participated in this study worked in the emergency, intensive care units, or general adult ward. The analysis focused on assessing participant attitudes towards patient safety culture in terms of both the overall score and sub-dimensions., Results: The participants were mostly female and between 21 and 30 years old. A majority had completed a diploma or university education. The two analyses revealed the highest and lowest average scores were earned, respectively, in the "teamwork" and "resilience" dimensions of patient safety culture. In 2020, the average scores for all dimensions were lower than in 2018, and the average scores for the emergency and critical care group were lower than those for the general adult ward group. Sub-dimension analysis showed that the general adult ward group earned significantly higher scores in "teamwork" across all three sub-dimensions compared to the emergency and critical care groups. The general ward group exhibited the most significant score decline between the two surveys., Conclusions / Implications for Practice: Overall scores were found to have decreased during the COVID-19 pandemic period (2020). Notably, emergency and intensive care nurses earned consistently lower scores, likely due to the severity of patient conditions and increased pandemic-related workloads and stress. "Resilience" scores were the lowest among all nursing staff, with the most significant drop seen in general ward nurses. Enhancing nursing staff education and training as well as addressing their psychological well-being will be crucial to improving patient safety culture attitudes. Managers should provide infection control, resilience training, and psychological counseling to help nurses manage the challenges posed by infectious diseases effectively and enhance patient safety culture.

The global pandemic of coronavirus disease 2019 (COVID-19) poses a serious threat to human health, leading to a relatively high mortality in patients with severe or critical conditions in particular. Hyperglycemia is one of the high-risk factors for poor prognosis in these patients. Patients with COVID-19 are more likely to develop hyperglycemia, regardless of whether there is a previous history of diabetes mellitus. Glucocorticoid therapy is an important part of the anti-inflammatory regimen for COVID-19. However, the use of glucocorticoid significantly increases the occurrence of hyperglycemic events in COVID-19 patients, ultimately leading to poor prognosis. Timely monitoring of blood glucose and early intervention for hyperglycemia contribute to the improvement in the outcome of COVID-19 patients. In this paper, we comprehensively reviewed the potential mechanisms of COVID-19 and concomitant hyperglycemia. We reviewed the latest findings on the blood glucose management strategies for COVID-19 patients with concomitant hyperglycemia, aiming to optimize the management of hyperglycemia in COVID-19 patients and improve the outcome of the disease., Competing Interests: 利益冲突　所有作者均声明不存在利益冲突, (© 2024《四川大学学报（医学版）》编辑部 版权所有Copyright ©2024 Editorial Board of Journal of Sichuan University (Medical Sciences).)

本研究旨在探討2019年COVID-19疫情以及相關輿情對幼兒社會情緒發展研究趨勢的影響，以文獻計量學方式，分析出疫情期間幼兒社會情緒發展科學研究合作的主要作者、國家及地區、作者共同合作、領域共現、文獻共被引、文獻耦合及共詞網絡之網絡聚類，找出研究趨勢與社群。本研究從Web of Science資料庫中選取2020年至2022年間822筆相關文獻，透過BibExcel文獻計量工具，以Pajek與Excel繪製圖表分析出結果：最具影響力的主要作者為澳洲墨爾本大學的P. Eadie等六人；主要國家及地區為巴西；主要領域共現為教育及教育研究，主要的共被引文獻為Samuelsson等人（2020）的“The Coronavirus Pandemic and Lessons Learned in Preschools in Norway, Sweden and the United States: OMEP Policy Forum”，主要文獻耦合為Eadie等人（2022）的“Challenges and Supports for Educator Well-Being: Perspectives of Australian Early Childhood Educators during the COVID-19 Pandemic”，主要共詞為COVID-19。最後，本研究建議以不同文獻計量工具分析，作為後續相關研究之交叉驗證，有助於更深入地瞭解OVID-19疫情對相關研究以及未來趨勢的影響。 Research Purpose The critical importance of early childhood social-emotional development for learning, school performance, and future life outcomes is well established. Ren et al. (2016) emphasized that social-emotional competence predicts school readiness, academic achievement, and psychological well-being and thus influences academic success and life outcomes in adulthood. Given the adverse effects of the COVID-19 pandemic on humans— including social isolation, restrictions that like growing apart, school and office closures, and uncertainty on emotional words this study investigated how the pandemic affected social-emotional development in young children. Research Motivation 1. Diverse Research Landscape: The rapidly evolving field of early childhood development is added to with multiple studies each year. Thus, understanding key topics, trends, and interdisciplinary areas is crucial for researchers and policymakers. 2. Influence of COVID-19 on Research Trends: The COVID-19 pandemic substantially affected society, lifestyle and learning models. Analyzing how this global event influenced research regarding early childhood social-emotional development could provide crucial insights for academia and policy. 3. Enhancing Policy Relevance: Bridging the gap between academic research and policy implementation remains vital. Analyzing the dynamics of research regarding early childhood social-emotional development could deepen academic understanding and provide evidence to inform policy decisions that benefit society. Literature Review 1. Foundational Theories of Social-Emotional Development in Early Childhood: This section discusses foundational theories proposed by Erikson (1968) in “Identity: Youth and Crisis”; Bowlby (1969) in “Attachment and Loss: Attachment, Vol. 1”; Bandura (1977) in “Social Learning Theory”; and Vygotsky (1978) in “Mind in Society: The Development of Higher Psychological Processes.” 2. Key Research Trends and Relevant Studies Regarding Social-Emotional Development in Early Childhood: Following the logic of scientific literature growth stages introduced by De Solla Price (1965), this section delineates research trends across two periods, namely 1986-2009 and 2010-2022, to highlight research topics and significant studies published in these periods. (1) 1986-2009 This period covers research topics including (1) emotional regulation and behavioral problems in young children, (2) the influence of family environment on social-emotional development, (3) effects of peer relationships, (4) the development of self-identity, (5) emotional expression and cognitive development, and (6) the relationship between family interactions and children’s emotions. Notable studies are cited for each of these topics. (2) 2010-2022 This period covers research topics including (1) the development of emotional identification and expressive skills, (2) emotional regulation and self-control abilities, (3) emotional development and social relationships, and (4) emotional distress and mental health challenges. Notable studies are cited for each of these topics. 3. Systematic Literature Reviews: This section highlights key literature reviews conducted by Rouhollah et al. (2018), Blewitt et al. (2018) and Djamnezhad et al. (2021) to offer comprehensive insights into key trends in research regarding early childhood social-emotional development. Research Methods The present research methodology utilizes key search terms such as “early childhood,” “education,” “social-emotional development,” “COVID-19,” and related combinations of key words with Boolean logic operators. The document types considered were defined as “Article,” “Early Access,” and “Review Article.” In total, 822 documents were retrieved from the Web of Science database for 2020-2022. Using BibExcel and visualization tools such as Pajek and Excel, the present analysis identified primary authors, countries, collaborative patterns, co-occurrence of research domains, frequently cited documents, document co-citation, and word co-occurrence networks during the pandemic period, thereby determining trends and academic communities in research regarding early childhood social-emotional development. Research Results The research results are presented across the following seven sections: 1. Primary Authors The primary authors are six scholars from the University of Melbourne, Australia, led by Eadie, P. However, the analysis of the relationship between the COVID-19 pandemic and social-emotional development in early childhood identified nine primary authors who published related journal articles between 2020 and 2022, forming a basis for co-occurrence analysis and exploration of the COVID-19 pandemic’s effect on social-emotional development in early childhood. 2. Country and Region Among 27 countries, Brazil was identified as the most closely cooperating country and acted as a crucial mediator influencing information dissemination and exchange. This outcome indicated Brazil’s vital role in the flow of information and knowledge in scholarly collaboration on the academic social network. 3. Author Cooperation Scholars from the University of Melbourne— particularly P. Eadie, P. Levickis, L. Murray, J. Page, C. Elek, and A. Church— were central nodes with the highest absolute centrality score of 5, signifying direct connections. Another group, led by scholars from the University of Colorado Denver, exhibited a distinct centralization pattern. 4. Co-Occurrence Education and educational research held the most central position, closely followed by psychology and development and then psychology and education. The strongest network association was that between education and educational research and psychology and development, indicating that these domains were the primary co-occurring research domains. 5. Co-Citation “The Coronavirus Pandemic and Lessons Learned in Preschools in Norway, Sweden and the United States: OMEP Policy Forum,” which emphasized measures to protect the health of educators and children and to ensure continuity in learning and development, was the most frequently cited document (8 times). That report shared experiences from Sweden, Norway, and the United States related to early childhood education during the COVID-19 pandemic. 6. Document Coupling Articles #24 (“Challenges and Supports for Educator Well-Being: Perspectives of Australian Early Childhood Educators during the COVID-19 Pandemic”) and #15 (“Early Childhood Educators’ Well-being during the COVID-19 Pandemic”), which discuss the pandemic’s effects from the perspective of early childhood educators— covering mental health, workload, and occupational stress and addressing the needs of parents and children— had the highest document coupling count (15). 7. Co-Word Network The most frequently used words were “COVID-19” (35 occurrences), “Early Childhood Education” (20 occurrences), and then “Early Childhood” (7 occurrences). The overall word co-occurrence network had a relatively low density, namely 0.23822715, with strong relationships between COVID-19 and key terms including “Early Childhood Education,” “Teachers,” “Pandemic,” “Early Childhood Teachers,” “Early Childhood Education and Care” and “Distance Education.” Discussion and Suggestions Research regarding the effects of COVID-19 on the social-emotional development of young children has primarily focused on emerging topics such as teacher well-being and challenges in remote learning, along with corresponding solutions. During the pandemic period, safeguarding the rights of early childhood educators was essential to ensure ample educational resources. The analyzed studies address emerging themes that shed light on the status of and shifts in research concerning social-emotional development in early childhood. As the pandemic subsides, observing evolving research trends and comprehensively examining the theoretical and practical aspects of early childhood social-emotional development is crucial. This paper proposes the use of multiple bibliometric tools as a form of cross-validation for follow-up research to explore the influence of public opinion on the development of related research trends.

本研究旨在瞭解在COVID-19線上教學期間教師情緒勞務中的淺層展現與深層展現對自我效能感的影響，並檢視教學正念於淺層展現與深層展現對自我效能感影響關係的調節效果。研究方法為問卷調查法，研究對象為於新冠疫情期間具線上教學經驗之臺灣國小教師，有效樣本為644份。研究使用多元迴歸分析進行假設檢驗。研究結果發現，因COVID-19疫情採線上教學期間，教師淺層展現程度愈高，則自我效能感愈低；教師深層展現程度愈高，則自我效能感愈高，本研究進一步發現教學正念對深層展現影響自我效能感的加乘效果不顯著、正念程度高的教師在進行淺層展現時對自我效能感的降低程度與正念程度低的教師無顯著差異。本研究建議學校聘請專家進行教師情緒調控之培訓課或鼓勵教師參與相關研習課程，多採深層展現進行教學，提升教師自我效能感。 Introduction Following its outbreak in 2019, the COVID-19 pandemic caused a considerable shift in work patterns across multiple industries. Taiwan continued education through online platforms, maintaining a “no suspension of classes” approach to ensure uninterrupted teaching and student learning. However, this transition imposed challenges on teachers, many of whom faced substantial stress and anxiety due to the demands of online teaching. Accordingly, this study focused on emotional labor, specifically surface acting and deep acting, as antecedent variables. During online teaching, teachers must maintain a strong belief in and enthusiasm for teaching to effectively foster student engagement and learning outcomes. The present study selected teacher self-efficacy as its outcome variable and explored the effects of surface acting and deep acting on teacher self-efficacy in the context of online teaching. The relevant literature suggests that mindfulness in teaching can enhance the effectiveness of teaching strategies and mitigate emotional exhaustion in teachers, thereby warranting its inclusion as a moderating variable in this study. Relevant studies have indicated that surface acting in emotional labor diminishes individual well-being and lowers self-efficacy, whereas deep acting enhances individual well-being and increases self-efficacy. Furthermore, deep acting positively predicts classroom management self-efficacy, whereas surface acting negatively affects such self-efficacy. However, these findings are based on traditional face-to-face teaching methods and lack support from empirical research regarding the relationships among teachers’ surface acting, deep acting, and self-efficacy during the online teaching period prompted by the COVID-19 pandemic in Taiwan. Additionally, understanding of the moderating role of teaching mindfulness in the relationships among surface acting, deep acting, and teacher self-efficacy remains limited. Accordingly, this study aimed to determine (1) how teacher surface acting and deep acting influence teacher self-efficacy in the context of online teaching during the COVID-19 pandemic and (2) the moderating role of teaching mindfulness in the relationships among teacher surface acting, deep acting, and self-efficacy. Research Purpose This study examined how teacher emotional labor affected teacher self-efficacy during the online teaching period prompted by the COVID-19 pandemic in Taiwan and investigated the moderating role of teaching mindfulness in the relationship between teacher emotional labor and self-efficacy. The aim of this study was to clarify the differential effects of surface acting and deep acting on teacher self-efficacy in the context of online teaching. The results of this study are expected to contribute to practical implications for teaching and to suggest timely support and assistance for teachers engaged in online teaching in order to enhance overall teaching effectiveness within school organizations. Data Collection The present research methodology conducted a questionnaire survey targeting primary school teachers in Taiwan with experience of online teaching during the COVID-19 pandemic period. A total of 644 valid responses were collected. The study utilized an English scale from an internationally published journal. To ensure conceptual validity and to avoid any loss of meaning due to translation, a back-translation process was employed. In addition, adjustments were made to some wordings to suit the context of online teaching during the COVID-19 pandemic, and relevant explanations were added accordingly. This study employed the emotional labor scale developed by Diefendorff et al. (2005) to assess teacher surface acting and deep acting during online teaching in the pandemic period. The measurement tool for surface acting consisted of seven items, whereas the measurement tool for deep acting consisted of four items. The Teacher Self-Efficacy Scale developed by Tschannen-Moran and Hoy (2001) was employed to assess self-efficacy among teachers engaged in online teaching. This scale contains three dimensions— namely “Teaching Strategies” (four items), “Classroom Management” (four items), and “Student Engagement” (four items)— yielding a total of 12 items. The Mindfulness in Teaching Scale developed by Frank et al. (2016) was employed to assess teacher mindfulness. This scale comprises eight items across two dimensions: “Intrapersonal Mindfulness” (six items) and “Interpersonal Mindfulness” (two items). Data Analysis IBM SPSS Statistics version 20.0 was used to perform quantitative statistical analysis of the survey data. The data analysis methods utilized in this study included descriptive statistics, Pearson correlation, and multiple regression analysis. Multiple regression analysis was employed to examine how surface acting and deep acting influenced teacher self-efficacy and to investigate the moderating effects of teaching mindfulness. Results The study results revealed that during the period of online teaching prompted by the COVID-19 pandemic, higher levels of surface acting among teachers were associated with lower self-efficacy, whereas higher levels of deep acting were associated with higher self-efficacy. Furthermore, the moderating effect of teaching mindfulness on the relationship between deep acting and self-efficacy was not significant. Finally, no significant difference was found in the reduction of self-efficacy between teachers with high levels of mindfulness who engaged in surface acting and those with low levels of mindfulness. Recommendations At the school level, organizational culture can substantially affect teachers’ emotional labor. Organizations can enhance the substance of a teacher’s job structure while fostering a school culture based on mutual trust and support. These actions are particularly crucial in the context of online teaching, where support for teachers’ instructional efforts is even more essential. Hiring experts to conduct training or relevant workshops related to emotional regulation for teachers can empower educators to apply their professional knowledge to develop personalized emotional expression skills. Such skill development can, in turn, improve teachers’ foundational ability to control their emotions and thus align with external expectations regarding their educational goals. In the context of online teaching, supporting teachers in managing their emotions appropriately and effectively by using emotional labor strategies is crucial for enhancing the effectiveness of online teaching. Suggestions for Future Research Future research should incorporate genuine emotional expression into strategies for emotional labor. Although this study analyzed only teachers from primary schools in Taiwan, it did not specifically analyze numbers of teachers in different regions. Accordingly, future research could investigate the distribution of teachers on the basis of the geographical locations of the primary schools where they teach. Because teachers are embedded within schools and because each school may have unique resources and methods of supporting online teaching, teachers from a single school often share certain common traits. Future research could utilize hierarchical linear modeling to explore relationships among variables at different levels. Finally, this study employed a quantitative research approach, and the self-reported data obtained limited the in-depth understanding of the participants’ performance in emotional labor and self-efficacy. Accordingly, future research is recommended to employ qualitative methods, such as interviews, to collect data and verify the authenticity of self-reported information.

Coronavirus disease 2019 (COVID-19) has continued to spread globally since late 2019, representing a formidable challenge to the world's healthcare systems, wreaking havoc, and spreading rapidly through human contact. With fever, fatigue, and a persistent dry cough being the hallmark symptoms, this disease threatened to destabilize the delicate balance of our global community. Rapid and accurate diagnosis of COVID-19 is a prerequisite for understanding the number of confirmed cases in the world or a region, and an important factor in epidemic assessment and the development of control measures. It also plays a crucial role in ensuring that patients receive the appropriate medical treatment, leading to optimal patient care. Reverse transcription-polymerase chain reaction (RT-PCR) technology is currently the most mature method for detecting viral nucleic acids, but it has many drawbacks. Meanwhile, a variety of COVID-19 detection methods, including molecular biological diagnostic, immunodiagnostic, imaging, and artificial intelligence methods have been developed and applied in clinical practice to meet diverse scenarios and needs. These methods can help clinicians diagnose and treat COVID-19 patients. This review describes the variety of such methods used in China, providing an important reference in the field of the clinical diagnosis of COVID-19.

The peak of COVID-19 infections in China has just passed, and symptomatic manifestations in patients vary widely, with a minority experiencing severe morbidity and mortality. Early detection of adverse outcomes remains critical for clinical governance and prognosis in COVID-19. This review synthesized both national and international studies relevant to the prognostic evaluation of COVID-19 and summarized the prognostic implications of demographics (age and gender), specific laboratory parameters, adjunctive examination results, complications, and comorbidities in COVID-19 patients. Pertinent laboratory parameters chiefly included markers of inflammation, coagulation function, and electrolytic balance. Adjunctive examinations included thoracic CT and electrocardiographic evaluations. Major complications and comorbid conditions included thrombotic episodes, co-infections, secondary infections, chronic pulmonary disorders, cardiovascular diseases, acute and chronic renal diseases, diabetes mellitus, and cerebrovascular accidents. Moreover, this article discussed how these elements affected the prognosis of patients with COVID-19. By summarizing the information, it aimed to inform preventive and therapeutic strategies against COVID-19 infections in the forthcoming period.

The COVID-19 epidemic has spread to the whole world for three years and has had a serious impact on human life, health and economic activities. China's epidemic prevention and control has gone through the following stages: emergency unconventional stage, emergency normalization stage, and the transitional stage from the emergency normalization to the "Category B infectious disease treated as Category B" normalization, and achieved a major and decisive victory. The designated hospitals for prevention and control of COVID-19 epidemic in Tianjin has successfully completed its tasks in all stages of epidemic prevention and control, and has accumulated valuable experience. This article summarizes the experience of constructing a hospital infection prevention and control system during the "Category B infectious disease treated as Category A" period in designated hospital. The experience is summarized as the "Cluster" hospital infection prevention and control system, namely "three rings" outside, middle and inside, "three districts" of green, orange and red, "three things" before, during and after the event, "two-day pre-purification" and "two-director system", and "one zone" management. In emergency situations, we adopt a simplified version of the cluster hospital infection prevention and control system. In emergency situations, a simplified version of the "Cluster" hospital infection prevention and control system can be adopted. This system has the following characteristics: firstly, the system emphasizes the characteristics of "cluster" and the overall management of key measures to avoid any shortcomings. The second, it emphasizes the transformation of infection control concepts to maximize the safety of medical services through infection control. The third, it emphasizes the optimization of the process. The prevention and control measures should be comprehensive and focused, while also preventing excessive use. The measures emphasize the use of the least resources to achieve the best infection control effect. The fourth, it emphasizes the quality control work of infection control, pays attention to the importance of the process, and advocates the concept of "system slimming, process fattening". Fifthly, it emphasizes that the future development depends on artificial intelligence, in order to improve the quality and efficiency of prevention and control to the greatest extent. Sixth, hospitals need to strengthen continuous training and retraining. We utilize diverse training methods, including artificial intelligence, to ensure that infection control policies and procedures are simple. We have established an evaluation and feedback mechanism to ensure that medical personnel are in an emergency state at all times.

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Objective: To examine the impact of COVID-19 pandemic on the epidemic status of imported malaria and national malaria control program in China, so as to provide insights into post-elimination malaria surveillance., Methods: All data pertaining to imported malaria cases were collected from Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 through December 31, 2021. The number of malaria cases, species of malaria parasites, country where malaria parasite were infected, diagnosis and treatment after returning to China, and response were compared before (from January 1, 2018 to January 22, 2020) and after the COVID-19 pandemic (from January 23, 2020 to December 31, 2021)., Results: A total of 2 054 imported malaria cases were reported in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region during the period from January 1, 2018 to December 31, 2021, and there were 1 722 cases and 332 cases reported before and after the COVID-19 pandemic, respectively. All cases were reported within one day after definitive diagnosis. The annual mean number of reported malaria cases reduced by 79.30% in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region after the COVID-19 pandemic (171 cases) than before the pandemic (826 cases), and the number of monthly reported malaria cases significantly reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region since February 2020. There was a significant difference in the constituent ratio of species of malaria parasites among the imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic ( χ 2 = 146.70, P malaria was predominant before the COVID-19 pandemic (72.30%), while P. falciparum malaria (44.28%) was predominant after the COVID-19 pandemic, followed by P. ovale malaria (37.65%). There was a significant difference in the constituent ratio of country where malaria parasites were infected among imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic ( P. falciparum malaria (37.65%). There was a significant difference in the constituent ratio of country where malaria parasites were infected among imported malaria cases in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region before and after the COVID-19 pandemic ( χ 2 infections in western Africa reduced after the COVID-19 pandemic that before the pandemic (44.13% vs. 37.95%; P < 0.05), and the proportion of malaria cases that acquired Plasmodium infections in western Africa reduced after the COVID-19 pandemic that before the pandemic (44.13% vs. 37.95%; χ infections in eastern Africa increased after the COVID-19 pandemic that before the pandemic (9.58% vs. 15.36%; 2 = 4.34, P = 0.02). The proportion of completing case investigation within 3 days was significantly lower after the COVID-19 pandemic than before the pandemic (96.69% vs. 98.32%; Plasmodium infections in eastern Africa increased after the COVID-19 pandemic that before the pandemic (9.58% vs. 15.36%; χ < 0.05), while the proportion of finishing foci investigation and response within 7 days was significantly higher after the COVID-19 pandemic than before the pandemic (100.00% vs. 98.43%; 2 = 9.88, P = 0.02). The proportion of completing case investigation within 3 days was significantly lower after the COVID-19 pandemic than before the pandemic (96.69% vs. 98.32%; χ 2 = 3.87, P < 0.05), while the proportion of finishing foci investigation and response within 7 days was significantly higher after the COVID-19 pandemic than before the pandemic (100.00% vs. 98.43%; χ 2 = 3.95, P < 0.05)., Conclusions: The number of imported malaria cases remarkably reduced in Anhui Province, Hubei Province, Henan Province, Zhejiang Province and Guangxi Zhuang Autonomous Region of China during the COVID-19 pandemic, with a decreased proportion of completing case investigations within 3 days. The sensitivity of the malaria surveillance-response system requires to be improved to prevent the risk of secondary transmission of malaria due to the sharp increase in the number of imported malaria cases following the change of the COVID-19 containment policy.

本研究旨在探討新冠疫情期間臺灣青少年學習適應與幸福感的現況與其相關。預試階段以便利取樣選取120位青少年填寫「臺灣中學生因應新冠疫情學習適應與幸福感問卷」，內容包含「基本資料」、「學習適應量表」及「幸福感量表」三部分。兩份量表─「學習適應量表」及「幸福感量表」，再以探索性因素分析和內部一致性信度檢驗兩份研究工具之信、效度後形成正式量表，其中，「學習適應量表」萃取出「到校上課」、「主動學習」、「遠距學習」等因素，共解釋57.86%變異量，總量表內部一致性信度為.88；「幸福感量表」萃取出「生活態度」、「生活滿意度」、「自我認同」等因素，共解釋60.19%變異量，總量表內部一致性信度為.95。正式施測階段以Google表單蒐集890位青少年資料並進行獨立樣本t檢驗、變異數分析，比較不同背景青少年在新冠疫情期間學習適應與幸福感之差異。最後再以結構方程模式檢驗各個潛在變數間之相關性及其預測力。資料分析結果發現，新冠疫情期間女學生、國中生和北部青少年分別比男學生、高中職學生及南部學生更期待返校實體上課。女生的自我認同感分數顯著高於男生，國中生的幸福感顯著高於高中職學生，居住南部青少年的生活滿意度顯著高於居住北部青少年。此外，結構方程模式分析發現「到校上課」能顯著正向預測臺灣青少年的「幸福感」。本研究結果可以作為未來相關研究及學校面臨重大疫情時規劃課程與教學之參考。 The COVID-19 pandemic led to considerable global morbidity and mortality between 2019 and 2022, prompting governments worldwide to close schools to prevent virus transmission. In early 2020, more than 180 countries suspended face-to-face classes in schools, disrupting the education of millions of students and leading to learning losses for children and adolescents. Investigations have revealed that some students lacked the necessary equipment for online learning and were therefore prevented from attending classes, while others intentionally skipped classes. I addition, surveys have indicated that the number of adolescents and young adults self-reporting mental health problems increased because of social isolation and a lack of face-to-face interaction with others. These findings suggest that during the COVID-19 pandemic period, poor learning performance and the mental health status of adolescents required close attention. In Taiwan, schools were closed twice from 2020 to 2022 to protect students from COVID-19. Learning adaptation refers to students’ learning skills, study plans, learning habits, learning interests and attitudes, learning environment, learning concepts, and physical and mental health. Researchers have suggested that learning adaptation is a dynamic process in which individuals adopt appropriate learning skills and strategies and use environmental resources to solve learning problems that they encounter. An individual’s well-being derives from their subjective perception of happiness rather than objective measures employed by others. The concept of subjective well-being (SWB) was originally proposed to encompass life satisfaction, positive mood, and negative mood. In 1989, Ryff redefined SWB and proposed the concept of psychological well-being (PWB), which covers six dimensions: self-acceptance, positive relationships with others, autonomy, environmental mastery, purpose in life, and personal growth. Researchers have since suggested that although PWB and SWB differ structurally, they correlate to varying degrees with factors including gender, age, educational status, emotion, self-awareness, and environment. In addition, related studies have found that well-being can elevate learning motivation and promote academic performance. The present study explored the differences and prediction in learning adaptation and well-being among Taiwanese adolescents during the COVID-19 pandemic period. The researchers constructed a research framework based on Bandura’s triadic theory of learning and related research findings. The following hypotheses were proposed: (1) The learning adaptation status of Taiwanese adolescents during the COVID-19 pandemic period differed on the basis of gender, educational status, and region of residence. (2) Each individual’s state of well-being during the COVID-19 pandemic varied depending on gender, educational status, and region of residence. (3) Taiwanese adolescents’ learning adaptation was positively correlated with their happiness levels during the COVID-19 pandemic. (4) The status of Taiwanese adolescents’ learning adaptation predicted their well-being during the COVID-19 pandemic. The researchers developed and validated two well-structured scales: the Learning Adaptation Scale and the Well-Being Scale. In the pilot stage of this study, 120 adolescents participated, and in the formal stage, 890 adolescents were recruited using Google Forms. Subsequently, the researchers performed exploratory factor analysis and internal consistency tests and conducted independent-samples t tests, an analysis of variance, and structural equation modeling to compare differences and relationships between adolescents’ learning adaptation and well-being in relation to multiple demographic variables during the COVID-19 pandemic. The Learning Adaptation Scale extracted three factors— namely going to school, active learning, and distance learning— which explained 57.859% of the variation. The scale’s overall internal consistency reliability was .878. The Well-Being Scale extracted three factors— namely life attitude, life satisfaction, and self-identity— which explained 60.187% of the variation. The scale’s overall internal consistency reliability was .950. The data analysis results revealed that during the suspension of in-person classes due to the COVID-19 pandemic, girls were more eager to return to school than were boys, junior high school students were more willing to return to school than were high school students, and adolescents living in northern Taiwan more eager to return to school than were those living in southern Taiwan. Girls had significantly higher self-identity scores than boys, and junior high school students scored significantly higher in self-efficacy than high school students did. Additionally, students living in southern Taiwan had significantly higher scores for life satisfaction than did those living in northern Taiwan. Finally, structural equation modeling revealed that “attending school” significantly and positively predicted the well-being of Taiwanese adolescents. This paper proposes the following suggestions for further research and application of the present findings in education: (1) Collect a higher quantity of samples using a random sampling selection method and conduct case studies or focus group interviews encompassing more regions of Taiwan to gain a clearer understanding of the current situation of adolescents’ learning adaptation and well-being throughout Taiwan. (2) Given that adolescents’ learning adaptation and well-being continuously change because of evolutions in environments and related factors, conducting a longitudinal study and establishing a large database to track such changes are highly recommended. Maintaining such a database could help identify problems early and could facilitate the formulation of effective strategies for improvement. Such a database could also provide references for education-related policy formulation and strategies. (3) The results of this study indicate that in Taiwan, an adolescent’s learning environment can effectively improve their well-being. Since online learning is regarded as another approach other than traditional learning. Schools at all levels should develop comprehensive support plans as soon as possible to address potential major and immediate changes in education. As developing and evaluating long-distance courses and teaching methods, creating a supportive learning atmosphere and encouraging communication and interaction between teachers and students should be considered crucial evaluation indicators given that these factors can consistently maintain high learning motivation among students. In summary, the results of this study could serve as a reference for the development of long-distance curricula, teaching plans, and related research that could be adopted during severe epidemic periods in the future.

ObjectiveTo investigate the menstrual conditions of women infected with COVID-19 in Shanghai and analyze the influencing factors.MethodsFrom December 2022 to March 2023， menstrual data from 281 women infected with COVID-19 in Shanghai were collected with a questionnaire survey， including usual menstrual characteristics， the most recent menstrual period post-infection， symptoms of infection， and medication usage. According to the crossover period between the menstrual period and the infection period of the respondents， the samples were divided into two groups for comparative analysis： those whose menstrual and infection periods overlapped （positive group） and those whose menstruation started after conversion to virus-negative （negative conversion group）.ResultsAmong the 281 respondents， 196 （65.8%） experienced menstrual changes. Among them， 145 （51.6%） had changes in menstrual volume， color and texture， and 109 （38.8%） had changes in menstrual duration or cycle. Decreased menstrual volume （22.1%）， darker color （23.49%）， thicker texture （21.0%）， increased blood clots （16.7%）， and prolonged duration （21.8%） were observed in both groups. The rate of changes in menstrual volume， color， and texture was higher in the positive group （56.8%， 69/110） than that in negative group （37.3%， 76/171） （P

Background The elderly are at high risk for COVID-19 and incontinence, as well as a vulnerable population for incontinence-associated dermatitis (IAD). There has been a continuous exploration of how to provide good incontinence care to improve the effectiveness of preventing and treating IAD. Objective To investigate the effectiveness of two incontinence care plans based on guidelines for elderly COVID-19 patients with incontinence, in order to provide a reference basis for good incontinence care and prevention of IAD in such patients. Methods Using an exploratory intervention study design, 60 eligible patients with COVID-19 were selected as the study subjects from the surgical and internal medicine departments of Eastern Theater General Hospital, PLA, Daping Hospital, Amy Medical University, PLA, and Sir Run Run Hospital, Nanjing Medical University from December 26, 2022 to March 30, 2023. The study subjects were nonrandomly divided into the intervention group and control group, with 30 patients from the Eastern Theater Command General Hospital of PLA included in the intervention group and 30 patients from the other two hospitals included in the control group. Patients with IAD in both groups were also included in the intervention and control subgroups. The characteristics and types of incontinence in elderly COVID-19 patients were analyzed, the "AIMS Four Step Improved Incontinence" care plan (AIMS care plan) for the assessing incontinence and skin (A), identifying and managing risk (I), managing incontinence (M), and skin care (S) was modified based on the recommendations of the guidelines. The intervention group adopted the modified AIMS care plan, while the control group adopted a structured skin care plan, with continuous intervention for at least 14 days. The skin was inspected every shift and international standards were used to determine the occurrence of IAD and changes. The primary outcome indicator was the incidence of IAD in both groups of patients, and the secondary outcome indicators were the healing rate and healing time of IAD. The relevant clinical data of the two groups before and after intervention was collected and compared. Results The general data of the both groups of patients showed no statistically significant differences, which included gender, age, types of incontinence, frequency of incontinence, chronic comorbidities, serum albumin, hemoglobin, blood glucose, pulse oxygen concentration, and Braden scores (P>0.05). The incidence of IAD in 60 elderly COVID-19 patients with incontinence was 33.3% (20/60), of which the incidence of IAD was 43.3% (13/30) in the control group and 23.3% (7/30) in the intervention group; There was no statistically significant difference in the incidence of IAD between the two groups of patients (P>0.05). There was no statistically significant difference in the grading, and healing rate of IAD between the two subgroups of patients (P>0.05). Patients in the intervention subgroup had a delayed time to IAD occurrence (t=3.225, P=0.005), shorter time to IAD healing (t=2.644, P=0.020), and shorter hospitalization time (t=4.364, P

Background After infection with SARS-CoV-2, the body will experience symptoms such as hyposthenia, fatigue, and accelerated heart rate for a period of time. Current research institutions do not have a clear description of the persistent symptoms and causes of corona virus disease 2019 (COVID-19) . Objective To explore the correlation between the characteristics of fatigue and its related symptoms during the recovery period of COVID-19, and provide data reference for the scientific control of COVID-19. Methods The survey of COVID-19 was conducted in urban and rural areas of Guangzhou, Wuhan and Zhengzhou from December 2022 to February 2023, a total of 750 questionnaires were distributed and 732 questionnaires were recovered, with an effective rate of 97.6%. Among the 732 respondents, 356 were males (48.63%) and 376 were females (51.37%) ; the average age was (35.2±16.0) years. There were 526 infected individuals and 206 uninfected individuals. The infections and clinical symptoms of the respondents were statistically analyzed by using questionnaires, and the subjective fatigue level was measured using the Fatigue Scale-14 (FS-14), and the measurement results were analyzed for differences. Pearson correlation analysis was used to explore the correlation between clinical characteristics and fatigue levels in COVID-19, and binary Logistic regression analysis was used to explore the risk factors for fatigue in COVID-19. Results Fever was the most common symptom of COVID-19, accounting for 88.97% (468/526), the average maximum fever temperature in febrile patients was (38.96±1.35) ℃. The physical fatigue and overall fatigue scores of infected individuals were higher than those of uninfected individuals (P

An epidemiological investigation was conducted on a cluster epidemic of COVID-19 in the vaccinated population in Beijing in 2022, and serum samples were collected from 21 infected cases and 61 close contacts (including 20 cases with positive nucleic acid in the isolation observation period). The results of antibody detection showed that the IgM antibody of two infected persons was positive, and the IgG antibody positive rates of patients who were converted, not converted to positive and infected persons were 36.84% (7/19), 63.41% (26/41) and 71.43% (15/21), respectively. About 98.78% of patients had been vaccinated with the SARS-CoV-2 inactivated vaccine. The positive rate of IgG antibody in patients immunized with three doses of vaccine was 86.00% (43/50), which was higher than that in patients with one or two doses [16.12% (5/31)]. The antibody level of M ( Q 1 , Q 3 ) in patients immunized with three doses was 4.255 (2.303, 7.0375), which was higher than that in patients with one or two doses [0.500 (0.500, 0.500)] (all P values<0.001). The antibody level of patients who were vaccinated less than three months [7.335 (1.909, 7.858)] was higher than that of patients vaccinated more than three months after the last vaccination [2.125 (0.500, 4.418)] ( P =0.007). The positive rate and level of IgG antibody in patients who were converted to positive after three doses were 77.78% (7/9) and 4.207 (2.216, 7.099), respectively, which were higher than those in patients who were converted after one or two doses [0 and 0.500 (0.500, 0.500)] (all P values<0.05).

The coronavirus disease 2019 (COVID-19) has been a global epidemic for more than three years, causing more than 6.9 million deaths. COVID-19 has the clinical characteristics of strong infectivity and long incubation period, and can cause multi-system damage, mainly lung damage, clinical symptoms of acute respiratory distress syndrome (ARDS) and systemic multiple organ damage. The SARS-CoV-2 virus is still constantly mutating. At present, there is no global consensus on the pathological changes of COVID-19 associated deaths and even no consensus on the criteria for determining the cause of death. The investigation of the basic pathological changes and progression of the disease is helpful to guide the clinical treatment and the development of therapeutic drugs. This paper reviews the autopsy reports and related literature published worldwide from February 2020 to June 2023, with a clear number of autopsy cases and corresponding pathological changes of vital organs as the inclusion criteria. A total of 1 111 autopsy cases from 65 papers in 18 countries are included. Pathological manifestations and causes of death are classified and statistically analyzed, common pathological changes of COVID-19 are summarized, and analytical conclusions are drawn, suggesting that COVID-19 infection can cause life-threatening pathological changes in vital organs. On the basis of different health levels of infected groups, the direct cause of death is mainly severe lung damage and secondary systemic multiple organ failure.

Background: The World Health Organization officially declared an end to the COVID-19 Public Health Emergency three years after the initial outbreak of COVID-19. Healthcare providers worldwide were overwhelmed during the pandemic, which greatly affected the mental health and turnover intention of nurses. Conducting a systematic review of psychological distress in first-line nurses during the pandemic may facilitate future research on pandemic-related resilience., Purpose: A systematic review of the literature on psychological distress among first-line nurses caring for patients with COVID-19 was conducted., Methods: This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 Statement. We searched the CINAHL, PubMed, Embase, and Airiti Library databases using the English and Chinese keywords ("COVID-19 first-line nurse" OR "COVID-19 frontline nurse") AND ("psychological distress" OR "PTSD" OR "depression" OR "anxiety" OR "insomnia" OR "stress" OR "burnout" OR "fear") to identify Chinese and English articles published between December 2019 and March 2023. The quality of the included studies was assessed using tools from the Joanna Briggs Institute., Results: A total of 20 articles covering 16 quantitative studies and 4 qualitative studies were included in the analysis. The quantitative findings revealed that first-line nurses experienced high task load and moderate or above-average burnout. Between 19.1% and 72.3% of the first-line nurses reported stress, and more than 30% experienced insomnia. At the peak of the pandemic, anxiety and distress levels were high. At 8-week follow-ups, while anxiety had decreased, distress levels had not. Qualitative findings included the identification of fear as a common symptom of psychological distress in first-line nurses., Conclusions / Implications for Practice: Further research is needed to better support frontline caregivers and facilitate their recovery from the moderate to severe psychological distress associated with pandemics.

After the first outbreak of corona virus disease 2019 (COVID-19) at the end of 2019, it has caused multiple rounds of transmission in many countries around the world. Cancer patients are mainly elderly people, and the immunosuppression state caused by the tumor itself and anti-tumor treatment, more accompanying underlying diseases, and more hospital environmental exposure leading to a higher incidence of COVID-19 infection. The proportion of severe cases after infection is high, and the mortality is high. Therefore, based on the domestic and foreign research and clinical practice, the Expert Committee of Geriatric Cancer Prevention and Treatment of Chinese Society of Clinical Oncology launched a discussion based on the characteristics of cancer patients, including the epidemiology, clinical manifestations, differential diagnosis, definition and risk factors of severe cases, diagnosis and treatment recommendations, recovery of anti-tumor treatment and vaccination recommendations. To provide the corresponding suggestions for the clinical diagnosis and treatment of such patients.

Small tourism enterprises are pivotal in the development and evolution of the spatial dynamics of scenic tourism and are the principal contributors to tourism services and experiences. They constitute a tangible base and medium for developing tourism in scenic areas. However, amidst the challenges of the tourism crisis and disaster management, there is a noticeable deficiency in the theoretical focus and case study analysis concerning small tourism enterprises. This study delves into the effects of the COVID-19 pandemic on the tourism industry and its associated sectors. It emphasizes small tourism enterprises in the Xijiang Qianhu Miao Village scenic region, drawing from case observations and field research alongside comprehensive interviews to gather authentic data. This study utilizes the proceduralized grounded theory to elucidate the inherent principles and mechanisms behind the organizational resilience of small tourism enterprises facing the pandemic's impacts. Additionally, it pinpoints the critical elements influencing the development of organizational resilience in these enterprises. The findings reveal the following: 1) The interplay between organizational capabilities and influential factors collectively elucidates the genesis and robustness of organizational resilience among small tourism enterprises in scenic areas, with resilience emerging and intensifying through the synergistic influence of internal and external organizational elements. 2) Organizational capabilities represent the intrinsic rationale and conceptual framework underlying the development of organizational resilience in small tourism enterprises. Such resilient organizations exhibit fundamental abilities such as environmental observation, impact forecasting, crisis response, and reflective learning. In essence, small tourism enterprises adapt by monitoring and recognizing shifts in the external milieu, predicting the duration and ramifications of the pandemic, and crafting proactive strategies in response to pandemic-induced challenges based on external changes and internal shortcomings. Throughout the pandemic, new insights were assimilated into the operational and developmental strategies of small tourism enterprises through ongoing reflection, summarization, and learning. Prompt adaptations in business approaches contributed significantly to cultivating and reinforcing organizational resilience. 3) Initial resources, social capital, and support initiatives foster organizational resilience among small tourism enterprises in scenic locales. These components are crucial for ensuring organizational survival, enhancing resilience potential, and sculpting organizational resilience. Specifically, foundational resources such as property ownership, operator expertise and skills, and surplus funds are vital for building organizational resilience during a pandemic. Concurrently, the relational networks between small tourism enterprises and their stakeholders, alongside social capital stemming from operators' power dynamics and identity within the tourism context, markedly strengthen organizational resilience. Furthermore, tourism relief policies and interventions that modify tourist influx and business sustainability within scenic areas play a pivotal role in enhancing the resilience of small tourism enterprises. This study broadens the theoretical understanding based on case studies of organizational resilience in small tourism enterprises amid the pandemic. It offers theoretical insights and practical guidance for the ongoing management and adaptive regulation of these enterprises during tourism-related crises and disaster management scenarios.

This article reviews the relevant studies on the efficacy and safety of influenza, pneumococcal and COVID-19 vaccination among tumor patients worldwide in recent years. By combing and analyzing the retrieved literature, the results show that influenza and pneumococcal vaccination can significantly reduce the morbidity and hospitalization rate of infectious diseases in tumor patients, reduce the risk of cardiovascular events and death, and significantly improve survival prognosis. COVID-19 vaccination can also protect tumor patients, especially those who have completed full dose vaccination. Authoritative guidelines and consensuses worldwide all recommend that tumor patients receive influenza, pneumococcal and COVID-19 vaccines. We should carry out relevant researches, as well as take effective measures to strengthen patient education, so that tumor patients can fully experience the health protection brought by the vaccine to this specific group.

Objective: To investigate the predictive value of blood cell ratios and inflammatory markers for adverse prognosis in patients with primary Sjögren's syndrome (PSS) combined with coronavirus disease 2019 (COVID-19)., Methods: We retrospectively collected clinical data from 80 patients with PSS and COVID-19 who visited the Rheumatology and Immunology Department of the First Affiliated Hospital of Nanchang University from December 2022 to February 2023. Inclusion criteria were (1) meeting the American College of Rheumatology (ACR) classification criteria for Sjögren's syndrome; (2) confirmed diagnosis of COVID-19 by real-time reverse transcription polymerase chain reaction or antigen testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); (3) availability of necessary clinical data; (4) age > 18 years. According to the clinical classification criteria of the "Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia (trial the 10th Revised Edition)", the patients were divided into the mild and severe groups. Disease activity in primary Sjögren' s syndrome was assessed using the European League Against Rheumatism (EULAR) Sjögren' s syndrome disease activity index (ESSDAI). Platelet-lymphocyte ratio (PLR), C-reactive protein-lymphocyte ratio (CLR), erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and other laboratory data were compared between the two groups within 24-72 hours post-infection., Results: The mild group consisted of 66 cases with an average age of (51. 52±13. 16) years, and the severe group consisted of 14 cases with an average age of (52.64±10.20) years. Disease activity, CRP, platelets, PLR, and CLR were significantly higher in the severe group compared with the mild group ( P < 0.05). Univariate analysis using age, disease activity, CRP, platelets, PLR, and CLR as independent variables indicated that disease activity, CRP, PLR, and CLR were correlated with the severity of COVID-19 ( P < 0.05). Multivariate logistic regression analysis further confirmed that PLR ( OR =1.016, P < 0.05) and CLR ( OR =1.504, P < 0.05) were independent risk factors for the severity of COVID-19 in the critically ill patients. Receiver operator characteristic (ROC) curve analysis showed that the area under the curve (AUC) for PLR and CLR was 0.708 (95% CI : 0.588-0.828) and 0.725 (95% CI : 0.578-0.871), respectively. The sensitivity for PLR and CLR was 0.429 and 0.803, respectively, while the highest specificity was 0.714 and 0.758, respectively. The optimal cutoff values for PLR and CLR were 166.214 and 0.870, respectively., Conclusion: PLR and CLR, particularly the latter, may serve as simple and effective indicators for predicting the prognosis of patients with PSS and COVID-19.

Objective: To investigate the clinical features of coronavirus disease 2019 (COVID-19) in patients with aplastic anemia (AA) undergoing immunosuppressive therapy (IST) . Methods: In this prospective cohort study, we collected the demographic and clinical data of patients with AA and COVID-19 from December 1, 2022, to January 31, 2023. We described the clinical features of COVID-19 among patients with AA and evaluated the effects of IST on the signs and severity of COVID-19. Results: A total of 170 patients with AA and COVID-19 were included. The common early symptoms, including fever, dizziness or headache, muscle or body aches, and sore throat, disappeared within 1-2 weeks. Approximately 25% of the patients had persistent fatigue within 2 weeks. Many patients experienced cough after an initial 1-3 days of infection, which lasted for more than 2 weeks. There were no differences in the duration of total fever episodes and maximum body temperature when patients were stratified according to whether or not they underwent IST, by IST duration, or by use of anti-lymphocyte globulin (ALG) ( P >0.05). No differences were observed in the occurrence of symptoms in either the early or recovery stages when patients with AA were stratified according to whether or not they underwent IST, or by IST duration ( P >0.05). However, patients who received ALG had fewer fever episodes within 1 week after infection ( P =0.035) and more sore throat episodes within 2 weeks after infection ( P =0.015). There were no other significant differences in clinical symptoms between patients who did and patients who did not receive ALG ( P >0.05) . Conclusion: The majority of patients with AA and COVID-19 recovered within 2 weeks of noticing symptoms when treated with IST.

Objective: To investigate the value of lung protective ventilation strategy (LPVS) guided by driving pressure for preventing postoperative pulmonary complications (PPCs) in patients recovered from COVID-19 and optimize intraoperative respiratory management., Methods: From December, 2022 to February, 2023, a total of 118 patients recovered from COVID-19 within a month (ASA Ⅰ~Ⅲ, aged ≥18 years) undergoing elective non-cardiac surgeries under general anesthesia in our hospital were randomized equally into LPVS group and control group.The patients in LPVS group received a tidal volume of 6 mL/kg with an individualized PEEP guided by minimum driving pressure and lung re-expansion every 30 min, and those in the control group received conventional mechanical ventilation.The incidence of PPCs and hypoxemia and pulmonary ultrasound score of the patients were compared between the two groups., Results: There was no significant difference in the baseline data between LPVS group and the control group ( P >0.05).Compared with the control group, LPVS group showed significantly lower incidences of PPCs (16.95% vs 35.59%, χ 2 =5.294, P =0.021) and hypoxemia (15.25% vs 30.51%, χ 2 =3.890, P =0.049) with also lower pulmonary ultrasound scores (5.31±1.07 vs 8.32±2.34, t =8.986, P <0.001).The PEEP value, airway pressure and plateau pressure in LPVS group were significantly higher, but the driving pressure and the tidal volume were lower than those in the control group ( P <0.05)., Conclusion: LPVS guided by driving pressure can improve oxygenation and reduce the risk of PPCs in patients recently recovered from COVID-19.