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1. chinaXiv:202002.00017 [pdf]

自我肯定缓冲新冠疫情引发的焦虑反应:一项随机对照研究

李世峰; 吴艺玲; 张福民; 许琼英; 周爱保
Subjects: Psychology >> Social Psychology

当个体知觉到环境中存在威胁时,就会自动的引发个体的应激反应。而长期的应激会使个体产生一系列严重的心理和身体健康问题。大量的研究发现肯定自我价值可以缓冲由应激引发的负面情绪和身体反应。本研究通过实验的方法考察了肯定自我价值是否可以降低新冠肺炎(COVID-19)疫情引发的焦虑和抑郁情绪反应。220名被试被随机分配到自我价值肯定任务组或控制任务组,被试在干预前(2月2日)和一个星期后(2月9日)完成焦虑和抑郁测量。研究结果发现相对于控制组在一周后比前测时表现出更严重的焦虑情绪,自我价值肯定组在前测和一周后在焦虑情绪上没有显著的变化,这一效应在控制了性别、年龄、受教育水平和家庭年收入后仍然存在。这些结果表明简短的(约10分钟)对自我价值的反思可以帮助个体缓冲疫情引发的焦虑情绪反应。这一发现对于从社会心理的视角进行疫情防护提供了重要的科学证据。

submitted time 2020-03-27 Hits2475Downloads60 Comment 0

2. chinaXiv:202003.00026 [pdf]

Effective Treatment of Severe COVID-19 Patients with Tocilizumab

Xu, Xiaoling; Han, Mingfeng; Li, Tiantian; Sun, Wei; Wang, Dongsheng; Fu, Binqing; Zhou, Yonggang; Zheng, Xiaohu; Yang, Yun; Li, Xiuyong; Zhang, Xiaohua; Pan, Aijun; Wei, Haiming
Subjects: Medicine, Pharmacy >> Clinical Medicine

Background: In December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified in Wuhan, China, which spread rapidly and has become a world-wide public health challenge. We aimed to assess the efficacy of tocilizumab in severe patients with Corona Virus Disease-19 (COVID-19) and seek a new therapeutic strategy. Methods: The patients diagnosed as severe or critical COVID-19 in The First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) and Anhui Fuyang Second People’s Hospital were given tocilizumab in addition to routine therapy between February 5 and February 14, 2020. The changes of clinical manifestations, CT scan image, and laboratory examinations were retrospectively analyzed. Findings: Within a few days, the fever returned to normal and all other symptoms improved remarkably. Fifteen of the 20 patients (75.0%) had lowered their oxygen intake and one patient need no oxygen therapy. CT scans manifested that the lung lesion opacity absorbed in 19 patients (90.5%). The percentage of lymphocytes in peripheral blood, which decreased in 85.0% patients (17/20) before treatment (mean, 15.52 ± 8.89%), returned to normal in 52.6% patients (10/19) on the fifth day after treatment. Abnormally elevated C-reactive protein decreased significantly in 84.2% patients (16/19). No obvious adverse reactions were observed. Nineteen patients (90.5%) have been discharged on average 13.5 days after the treatment with tocilizumab and the rest are recovering well. Interpretation: Tocilizumab is an effective treatment in severe patients of COVID-19, which provided a new therapeutic strategy for this fatal infectious disease.

submitted time 2020-03-05 Hits61522Downloads16245 Comment 0

3. chinaXiv:202003.00005 [pdf]

Psychological responses to the Coronavirus Disease (COVID-19) outbreak

Zheng JIN; Kaibin ZHAO; Yanyu XIA; Ruijun CHEN; Huan YU; Timothy TAMUNANG TAMUTANA1; Jeffrey SHERMAN; Christina BERMEITINGER; Pamela BAESS
Subjects: Psychology >> Social Psychology

The novel coronavirus (COVID-19) has infected more than 90,000 people in at least 69 countries by Feb 29, 2020. Medical interest in COVID-19 has been considerable. Mental health issues that coincide with the epidemics are rarely examined. There is a strong need for public health officials to consider how psychological effects vary at each phase of a crisis and how they relate to people to better support them in these shifting states of mind. The present study examines temporal relationships among behavioral and emotional responses towards COVID-19 and attitudinal responses to crisis management. 846 adults were invited to complete a set of Internet-based questionnaires at two time points with a range of 14 to 18 days’ intervals covered by the ascending phase of the outbreak. At the baseline assessment 788 adults completed the questionnaires. At the Wave 2 survey, 318 adults from Wave 1 were retained. Results from cross-lagged models demonstrated reciprocal negative associations between anxiety and crisis management appraise. In addition, the higher evaluation of crisis management in the initial period of outbreak predicted adoption of preventive behaviors and susceptibility to emotional contagion to a greater extend in a later period. Susceptibility to emotional contagion also positively predicted preventive behaviors taken. Furthermore, multiple group structural equation modeling revealed that evaluation of crisis management is more likely to affect the susceptibility to emotional contagion of people on the frontline of the outbreak (i.e., Wuhan) compared to people living in moderate risk areas (i.e., Outside of Hubei). These data provide experimental evidence regarding mental health during the COVID-19 outbreak, and over the course of a pandemic, which will direct governments and health authorities during disease outbreaks through their attempts to communicate with the public.

submitted time 2020-03-04 Hits8272Downloads955 Comment 0

4. chinaXiv:202003.00003 [pdf]

COVID-19 outbreak increased risk of schizophrenia in aged adults

Hu, Wei; Su, Li; Qiao, Juan; Zhu, Jing; Zhou, Yi
Subjects: Psychology >> Clinical and Counseling Psychology

We noticed an unusual increase of first-time patients with schizophrenia (F20) in January 2020 since the outbreak of COVID-19. The aim of this retrospective study is to validate this observation and find potential risk factors, if applicable. A total number of 13,783 records from outpatients in January 2020 were investigated thoroughly. Comparisons between incidence of schizophrenia in outpatients in January 2020 and similar periods of 2017-2019 were made to minimize seasonal influence. Relationship of incidence of schizophrenia and COVID-19 infections in China was calculated. Limited personal information (age, gender, approximate residence) was analyzed to find risk factors.After excluding seasonal factors such as Spring festival, a positive relationship between incidence of schizophrenia in first-time patients and countrywide epidemic situation was found. Statistical results further showed a significant increase of median age from 39 to 50 for first-time patients diagnosed with schizophrenia which is unusual. Meanwhile, a slight but not significant change was found in distribution of gender and approximate residence (urban/suburb). Our data supported that COVID-19 outbreak increased risk of schizophrenia in aged adults which is consistent with the fact that COVID-19 is more lethal to elders. We strongly appeal that public healthcare in countries either with or without infected patients should prepare in advance for potential risks in public mental health.

submitted time 2020-02-29 Hits12192Downloads1324 Comment 0

5. chinaXiv:202002.00078 [pdf]

Confirmed asymptomatic carrier of SARS-CoV-2

Luo, Sihui; Liu, Wei; Liu, Zhenjun; Zheng, Xueying; Ling, Ping; Ding, Yu; Hong, Changxing; Liu, Zhirong; Liu, Jian; Weng, Jianping
Subjects: Medicine, Pharmacy >> Clinical Medicine

Here we reported a case of asymptomatic carrier of SARS-CoV-2 infection. A 50-year old woman, lived with her husband in Anqing(Anhui, China) with no significant past medical history, travel history to Wuhan or adjacent area, or exposure to wild animals. She took throat swab test for SARS-CoV-2 nucleic acid due to her husband’s close contact with patients who had SARS-CoV-2 infection. Her results were confirmed positive on February 6, 2020. But she did not report elevation of temperature measurement, nor respiratory or gastrointestinal symptoms and her chest CT scan showed no significant abnormalities. She was hospitalized on February 6 and treated with antiviral agents. During her hospitalization, apart from a mild elevation of liver enzymes after 10-day treatment of lopinavir/ritonavir, she was asymptomatic, with her blood cell count, live and renal function largely normal. Her subcutaneous oxygen saturation stayed above 97%. Chest CT scan was repeated on February 11 and 20, and both were negative for signs of viral pneumonia. Notably, a second set of throat swabs and anal swabs were sent to test for SARS-CoV-2 on February 19, and the results were still confirmed positive. This is a confirmed case of asymptomatic carrier of SARS-CoV-2 infection. Her persistent positive findings in both throat and anal swabs suggested the possibility of healthy carrier of the virus, which adds to the difficulty in preventing transmission of the disease.

submitted time 2020-02-28 Hits10915Downloads1239 Comment 0

6. chinaXiv:202002.00080 [pdf]

Transplantation of ACE2- mesenchymal stem cells improves the outcome of patients with COVID-19 pneumonia

Zikuan Leng; Rongjia Zhu; Wei Hou; Yingmei Feng; Yanlei Yang; Qin Han; Guangliang Shan; Fanyan Meng; Dongshu Du; Shihua Wang; Junfen Fan; Wenjing Wang; Luchan Deng; Hongbo Shi; Hongjun Li; Zhongjie Hu; Fengchun Zhang; Jinming Gao; Hongjian Liu; Xiaoxia Li
Subjects: Medicine, Pharmacy >> Clinical Medicine

A coronavirus (HCoV-19) has caused the novel coronavirus disease (COVID-19) outbreak in Wuhan, China, Preventing and reversing the cytokine storm may be the key to save the patients with severe COVID-19 pneumonia. Mesenchymal stem cells (MSCs) have been shown to possess a comprehensive powerful immunomodulatory function. This study aims to investigate whether MSC transplantation improve the outcome of 7 enrolled patients with COVID-19 pneumonia in Beijing YouAn Hospital, China from Jan 23, 2020. to Feb 16, 2020. The clinical outcomes, as well as changes of inflammatory and immune function levels and adverse effects of 7 enrolled patients were assessed for 14 days after MSC injection. MSCs could cure or significantly improve the functional outcomes of seven patients with COVID-19 pneumonia in 14 days without observed adverse effect. The pulmonary function and symptoms of all patients with COVID-19 pneumonia were significantly improved in 2 days after MSC transplantation. Among them, two common and one severe patient were recovered and discharged in 10 days after treatment. After treatment, the peripheral lymphocytes were increased and the overactivated cytokine-secreting immune cells CXCR3 CD4 T cells, CXCR3 CD8 T cells, and CXCR3 NK cells were disappeared in 3-6 days. And a group of CD14 CD11c CD11bmid regulatory DC cell population dramatically increased. Meanwhile, the level TNF-α is significantly decreased while IL-10 increased in MSC treatment group compared to the placebo control group. Furthermore, the gene expression profile showed MSCs were ACE2- and TMPRSS2- which indicated MSCs are free from COVID-19 infection. Thus, the intravenous transplantation of MSCs was safe and effective for treatment in patients with COVID-19 pneumonia, especially for the patients in critically severe condition.

submitted time 2020-02-28 Hits12383Downloads2786 Comment 0

7. chinaXiv:202002.00084 [pdf]

Clinical remission of a critically ill COVID-19 patient treated by human umbilical cord mesenchymal stem cells

Bing Liang; Junhui Chen; Tao Li; Haiying Wu; Wenjie Yang; Yanjiao Li; Jianchun Li; Congtao Yu; Fangang Nie; Zhaoxia Ma; Mingxi Yang; Panrong Nie; Yanfeng Gao; Chuanyun Qian; Min Hu
Subjects: Medicine, Pharmacy >> Clinical Medicine

Background The COVID-19 cases increased very fast in the last two months. The mortality among critically ill patients, especially the elder ones, was relatively high. Considering that most of the dead patients were caused by severe inflammation response, it is very urgent to develop effective therapeutic agents and strategies for these patients. The human umbilical cord mesenchymal stem cells (hUCMSCs) have shown very good capability to modulate immune response and repair the injured tissue with good safety. Case Presentation Here, we reported the treatment process and clinical outcome of a 65-year-old female critically ill COVID-19 patient infected with 2019-nCoV (now called SARS-CoV-2). The significant clinical outcome and well tolerance was observed by the adoptive transfer of allogenic hUCMSCs. Conclusions Our results suggested that the adoptive transfer therapy of hUCMSCs might be an ideal choice to be used or combined with other immune modulating agents to treat the critically ill COVID-19 patients.

submitted time 2020-02-27 Hits11676Downloads1708 Comment 0

8. chinaXiv:202002.00065 [pdf]

Potential of Arbidol for Post-exposure Prophylaxis of COVID-19 Transmission

Jinnong,Zhang; Wenjing,Wang; Bo,Peng; Wei,Peng; Yisheng,Zhang; Yaling,Wang; Yan,Wan; Jiang,Chang; Ling,Mao; Xiaoping,Miao; Yifan,Zhou; Yanan,Li; Yu,Hu; Bo,Hu
Subjects: Medicine, Pharmacy >> Clinical Medicine

Background: The efficient transmission of Severe Acute Respiratory Syndrome-2 Coronavirus (SARS-CoV-2) from patients to healthcare workers or family members has been a worrisome and prominent feature of the ongoing outbreak. On the basis of clinical practice and in-vitro studies, we postulated that post-exposure prophylaxis (PEP) using Arbidol is associated with decreased infection among individuals exposed to confirmed cases of COVID-19 infection. Methods: We conducted a retrospective case-control study on family members and health care workers who were exposed to patients confirmed to have SARS-CoV-2 infection by real-time RT-PCR and Chest CT from January 1 to January 16, 2020. We collected demographic information, work location of exposure, post-exposure prophylaxis information, and symptoms, if any, 24 days after exposure. The relation between post-exposure prophylaxis and infection in household contacts and healthcare workers were respectively analyzed. Results: 27 families and 124 health care workers had evidence of close exposure to patients with confirmed COVID-19. There were no differences in age, profession and sex distribution in the two groups with different post-exposure prophylaxis, table 1. Logistic regression based on the data of the family members and health care workers with Arbidol or Oseltamivir prophylaxis showed that Arbidol PEP was a strong protective factor against the development of COVID-19 (Odds ratio 0·011 , 95% CI 0·001-0·125, P=0·0003 for family members and Odds ratio 0·049, 95%CI 0·003-0·717), P= 0·0276 for health care workers). On the contrary, Oseltamivir was associated with an increase in COVID-19 infection (Odds ratio 20·446, 95% CI 1·407-297·143, P= 0·0271). Conclusions: Our findings suggest Arbidol could reduce the infection risk of the novel coronavirus in hospital and family settings. This treatment should be promoted for PEP use and should be the subject of further investigation.

submitted time 2020-02-26 Hits15615Downloads1383 Comment 0

9. chinaXiv:202002.00075 [pdf]

2019年新型冠状病毒导致的致命肺渗漏的病理生理学机制和防治策略

Chen, Sifeng
Subjects: Medicine, Pharmacy >> Preclinical Medicine

自2019年12月爆发以来,2019年新型冠状病毒已在全球造成2596人死亡,并且有超过11,000名患者仍处于严重状况。该病毒和由该病毒引起的医疗状况被命名为SARS-CoV-2和COVID-19。虽然已经广泛应用了抗病毒、对症和功能支持性疗法,每天仍有100多名患者死于该病毒感染。COVID-19最常见的致命并发症是急性呼吸窘迫综合征(ARDS)。SARS-CoV-2在世界范围内的大流行可能仍然存在。其它病毒感染引起的肺炎亦可导致ARDS,出现类似的危重情形,这些病毒包括如非典型的急性呼吸系统综合症(SARS)、中东呼吸综合征(MERS)和流感病毒引起的肺炎。因此,制定更有效的降低病毒所致的ARDS死亡率的策略,不但是当前抗新冠疫情的迫切需要,也是全球范围内降低病毒性肺炎死亡率的长期需要。ARDS曾被称为湿肺,血管泄漏导致的肺水肿是其最重要的病理特征之一,重型COVID-19的临床表现和胸部计算机断层扫描图像特征(白肺)符合ARDS。确定水肿液从何处及如何渗漏到肺部,是制定基于机制的预防和阻止水从肺毛细管向肺间质渗漏的策略,降低湿肺死亡率的关键。对于轻度和中度病例,非类固醇消炎药,如用于风湿性关节炎的药物,可能有助于防止和减少这种漏水。免疫抑制剂(如西罗莫司和巨蜥)可能使病毒感染、免疫反应和非免疫炎症造成的损伤高峰时间错开,从而降低肺漏水程度,防止危及生命情况出现。使用清火中草药可能也有抗炎用。对于严重病例,血液透析可能是消除大多数炎症介质和细胞毒性物质的有效策略。

submitted time 2020-02-25 Hits6142Downloads430 Comment 0

10. chinaXiv:202002.00063 [pdf]

Perspectives on Active Preventive Measures of Wuhan People against COVID-19 Epidemic at Home: A Comparative Study

zhidong,Xue; Lei,Zhao; Tailang,Yin; Yan,Fu; Zehua,Lyu; yiping,Dang; Yujiang,Zeng; Silou,Huang; Bing,Qu; Hongya,Lyu; Chen,Huang; Zhiyou,Kong; Kepei,Xu; Feipeng,Zhou; Hexun,Dong; He,Hu; Jing,Tang; Senyuan,Xue; Zhixiang,Fang; Jinxiang,Lu
Subjects: Computer Science >> Computer Application Technology

Background:The COVID-19 Epidemic emerged in Wuhan, Hubei province, China. Ever since Wuhan lockdown on January 23rd, mass quarantines were exercised on Wuhan and other epidemic areas of China. We aimed to clarify how ordinary Wuhan people defend against COVID-19 epidemic at home through the Internet survey. Methods:A questionnaire survey, consisting of 30 questions were posted on the Internet. The following aspects were investigated: household preventive measures, self-monitoring of discomfort symptoms, immunity boosting against the epidemic, frequency and reasons of outgoing and mental status of the isolated people. The questionnaire was circulated on Wechat. We marked the areas based on the surveyed network IP addresses and categorized respondents into group A(Wuhan), B(Hubei Province excluding Wuhan ), C, and D based on the epidemic severity of their areas announced by Baidu.com at 17:00 on February 8, 2020. And a comparative study was conducted to illustrate how Wuhan people took the anti-COVID-19 strategies and how efficient these preventive measures were. Findings:In terms of discomfort symptoms, Wuhan, as Group A, had the lowest asymptomatic percentages (70.2%), compared to the average 78.5% (±7%). Considering the three typical symptoms for the COVID-19, i.e., cough, fever and fatigue, Wuhan (9.67%) greatly deviated from the average (7.68%). The fatigue was the most significant factor in the deviation, exceeding the average by 1.35%. In terms of household protection measures, most people or families were able to take effective protection measures with very low frequency of going out, but the percentage of those who took this practice was obviously smaller in Wuhan and Hubei Province. From the aspect of going out, most of the people in Wuhan only went out for shopping and work, with a small number of people for social gathering. In terms of immunity boosting, compared with Group C and D, it was relatively lower in Wuhan. Overall, most people chose to enhance their immunity through regular schedule, exercise, sufficient nutrition. Only 33.44% of people in Group A did not go out, and 59.97% had to go out for living supplies, which was the highest level among the four groups. However, the percentage of people who went out for work and unnecessary activities remains the lowest while 1% of the population went out for public welfare activities, higher than other groups. Worry about the family health topped all the parameters for all the groups. Among them, Wuhan has reached a maximum of 49.61%, higher than the average level of 36.62% (± 10.69%). Mental status except for feeling bored and lonely were the highest in Wuhan. Suggestions:When the epidemic prevention and control is still in a sticky state, and Wuhan started a stricter control measure, the closed management of communities, on Feb 11, 2020, it is expected that our findings can provide some insights into the current household preventive actions and arouse more attentions of the public to some ignored preventive precautions. Unnecessary outgoing should be strictly abandoned. Regular schedule, exercises and nutrition were the top 3 measures participants would choose to enhance their own immunity system. It seems that people in Wuhan would choose nutrition and regular scheduler rather than exercises as the primary immunity-boosting ways. Exercise should be especially advocated as an effective way to enhance the immunity system. In terms of physical condition, people in Wuhan should take more active measures when symptoms occurred. The mentality is also an important aspect requiring intensive attention with the conduct of stricter control management in Wuhan while the rest groups gradually resume to work and ordinary life.

submitted time 2020-02-24 Hits6173Downloads297 Comment 0

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