Risk and Protective Factors Associated with Depression and Anxiety among Pregnant Women during the COVID-19 Pandemic

Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ2 test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.

Relationships among Sedentary Time,Electronic Product Addiction,and Depression in Adolescents during the COVID-19 Epidemic:A Cross-Lagged Study

Objective:This study was conducted to explore the relationships among sedentary behavior(SB),electronic product addiction(EPA),and depression(D)in adolescents during the COVID-19 epidemic.Methods:A total of 604 adolescents(including 309 girls and 295 boys aged 12-18)were selected from Qufu City,Shandong Province,China for three rounds of investigation.The model was constructed using AMOS 23.0 software,and cross-lagged analysis was conducted.Results:SB at T1 can significantly positively predict SB and EPA at T2(p<0.05).EPA at T1 can significantly positively predict SB and D at T2(p<0.05).Physical activity level and SB at T2 can significantly predict SB and EPA at T3(p<0.05).EPA at T2 can significantly predict SB,EPA,and D at T3(p<0.05).Conclusions:SB and EPA are predictive factors for D.Moreover,SB can significantly positively predict D and indirectly predict D through the mediating effect of EPA.

A Study on the Influences of the COVID-19 Pandemic-Related Depression, Anxiety, Stress, and Treatment-Crisis on Quality of Life in Cancer Patients - A Secondary Publication

Objective:To investigate the factors affecting the quality of life of cancer patients by examining the degree of the COVID-19 pandemic-related depression,anxiety,stress,and treatment crisis.Methods:Data were collected from 132 cancer patients undergoing surgery,chemotherapy,radiotherapy,and hormone therapy at K University Hospital in D City using a structured questionnaire.The period of data collection was from May 6 to May 28,2022.The collected data were analyzed using descriptive statistics,t-test,ANOVA,Pearson’s correlation,and stepwise multiple regression.Results:The mean scores of quality-of-life,depression,anxiety,stress,and treatment crisis during the COVID-19 pandemic were 84.64±29.09,15.14±6.49,4.66±5.27,75.83±17.70,and 78.52±19.95,respectively.In terms of factors affecting the quality of life related to the COVID-19 pandemic,COVID-19 pandemic-related stress(β=0.41,P<0.001)appeared to have the greatest impact,followed by COVID-19 pandemic-related treatment-crisis(β=0.28,P=0.002),anxiety(β=0.21,P=0.002),and gender(β=0.14,P=0.009),with a total explanatory power of 67.6%.Conclusion:To improve the quality of life during the COVID-19 pandemic,COVID-19 pandemic-related stress,treatment-crisis,and anxiety should be periodically monitored and nursing interventions such as education on infection prevention,management,and emotional support programs should be provided to decrease the COVID-19 pandemic-related stress,treatment-crisis,and anxiety.

Relationship between depression,smartphone addiction,and sleep among Chinese engineering students during the COVID-19 pandemic

BACKGROUND Existing research has demonstrated that depression is positively related to smartphone addiction, but the role of sleep has not been discussed thoroughly, especially among engineering undergraduates affected by the coronavirus disease 2019 pandemic.AIM To evaluate sleep as a mediator of the association between smartphone addiction and depression among engineering undergraduates.METHODS Using a multistage stratified random sampling method, a cross-sectional survey was conducted among 692 engineering undergraduates from a top engineering university in China, and data were collected by self-reported electronic questionnaires. The data included demographic characteristics, such as age, gender, the Smartphone Addiction Scale-Short Version(SAS-SV), the 9-item Patient Health Questionnaire, and the Pittsburgh Sleep Quality Index. Pearson correlation and multiple linear regression analyses were used to examine the association between smartphone addiction and depression, while structural equation models were established to evaluate the possible mediating role of sleep.RESULTS Based on the cutoffs of the SAS-SV, the rate of smartphone addiction was 63.58 percent, with 56.21 percent for women and 65.68 percent for men, among 692 engineering students. The prevalence of depression among students was 14.16 percent, with 17.65 percent for women, and 13.18 percent for men. Smartphone addiction was positively correlated with depression, and sleep played a significant mediating effect between the two, accounting for 42.22 percent of the total effect. In addition, sleep latency, sleep disturbances, and daytime dysfunction significantly mediated the relationship between depression and smartphone addiction. The mediating effect of sleep latency was 0.014 [P < 0.01;95% confidence interval(CI): 0.006-0.027], the mediating effect of sleep disturbances was 0.022(P < 0.01;95%CI: 0.011-0.040), and the mediating effect of daytime dysfunction was 0.040(P < 0.01;95%CI: 0.024-0.059). The influence of sleep latency, sleep disturbances, and daytime dysfunction accounted for 18.42%, 28.95%, and 52.63% of the total mediating effect, respectively.CONCLUSION The results of the study suggest that reducing excessive smartphone use and improving sleep quality can help alleviate depression.

Risk factors and strategies for prevention of depression, anxiety and eating disorders among adolescents during the coronavirus disease 2019 (COVID-19) pandemic: a review

The purpose of this review is to identify prevalent trends and risk factors in depression,anxiety,and eating disorders in the adolescent population in the post coronavirus disease 2019(COvID-19)scenario.We examined the literature published on adolescent mental health since the COVID-19 pandemic.We chose to summarize studies published from 2019 to 2022,using bibliographic search tools.We developed criteria for selecting articles for our review using diagnostic indicators and keywords.Mental health conditions such as depression,anxiety and eating disorders are commonly prevalent in this population and have shown increasing rates in the past three years.Some risk factors associated with these diagnoses include reduction in social interaction,increased workloads,routine shifts,sleep quality,social media usage and parental involvement.Routines,sleep cycles,physical activity,and social media should all be considered as a part of prevention in this population.Approaches that seem to be successful include maintaining social ties and avoiding negative social media usage with harmful content.Increased global public awareness,as well as parental awareness,through media campaigns,is critical to slowing the spread of mental health challenges in adolescents and teenagers in the post-COvID-19 era.

Review of the Depression Rate among Pregnant Women during the COVID-19 Pandemic

Purpose: To determine the incidence of depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022 through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society using the keywords “COVID-19”, “Pregnant Women” and “Depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;3) description of COVID-19. Results: Of the 213 articles that were extracted, 104 were excluded owing to duplication and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 49 were excluded by title, abstract, and full-text screening. Among the 46 articles that met the inclusion criteria, 13 articles (28.3%) were from China, 8 (17.4%) were from Turkey, 4 (8.7%) were from the United States, and 3 (6.5%) were from Japan. The most common scales used to measure depression were the Edinburgh Postnatal Depression Scale (EPDS) used in 18 articles (39.1%), followed by the Patient Health Questionnaire (PHQ-9) used in 11 articles (23.9%). Furthermore, 46 sources reported a suspected depression rate of 30.0% (20,338/67,860 pregnant women). The rate of depression was 15.1% - 33.5% using EPDS ≥ 9 in three articles and 12.0% - 43.2% using EPDS ≥ 13 in nine articles. The five articles using PHQ-9 ≥ 5 reported 25.8% - 48.7%, and seven articles reported 5.3% - 59.2% using PHQ-9 ≥ 10. Conclusion: Depression was a concern for one out of every three to four pregnant women during the COVID-19 pandemic. This suggests that depression among pregnant women during COVID-19 might have worsened, highlighting the need for mental health support for them.

Review of Factors Associated with Depression among Pregnant Women during the COVID-19 Pandemic

Purpose: This purpose of the study was to investigate the factors both risk and protective associated with depression among pregnant women during the coronavirus disease (COVID-19) pandemic. Methods: A literature search was conducted on July 2022, through PubMed, CINAHL, MEDLINE, CiNii, and the Japan Medical Abstract Society databases, with the keywords “COVID-19”, “pregnant women”, and “depression”. The titles/abstracts were screened based on three selection criteria: 1) inclusion of pregnant women;2) description of depression;and 3) description of the factors associated with depression among pregnant women during the COVID-19 pandemic. Results: Of the 213 articles extracted, 104 were excluded owing to duplication, and 14 were excluded because they comprised other article types, including reviews and commentaries. Finally, 40 were excluded by title, abstract, and full-text screening. Among the 45 articles for a total of 59,329 pregnant women that met the inclusion criteria, the risk factors were “distress from COVID-19-related experiences”, “reduced/low income”, “unemployment”, “anxiety”, “history of mental illness”, “lack of social support”, and “reduced/no exercise”. The protective factors “greater/increased social support”, “higher education level”, “higher resilience”, and “healthy lifestyle behaviors” were much less frequently reported than risk factors, and none were reported to be relevant for Japanese pregnant women. Conclusion: The findings indicate that preventive interventions should begin during pregnancy with a focus on these risk factors. In addition, the protective factors need to be strengthened. Further research is required to identify the protective factors associated with depression among Japanese pregnant women.

Sociopsychological impact factors of depression patients during the COVID-19 epidemic period

Objective:To investigate the impact factors of the COVID-19 epidemic on the mental health of patients with depression.Methods:The relevant data of 242 residents aged 18-50 years in a certain area were collected,118 patients and 124 healthy people were analyzed by general information questionnaire,the PsychoSocial Index(PSI)questionnaire,Social Support Rating Scale(SSRS)and Symptom Checklist 90(SCL-90).Compare the differences in social and psychological factors between the two groups.Then use logistic regression to evaluate the social and psychological influencing factors of depression patients during the epidemic.Results:Two results of logistic regression analysis showed that marital status,occupational status,abnormal pathological behavior,and utilization of support were still significantly associated with depression.Compared to working,unemployed/unemployed/retired,students are closely related to depression,followed by abnormal pathological behavior and utilization of support.Conclusion:Under the epidemic,depression groups lacking social relationships should actively pay attention to their mental health status and comprehensively enhance their social and psychological support.To avoid the exacerbation of psychological and psychological symptoms caused by the epidemic.

基于CiteSpace及VOSviewer的COVID-19相关心律失常的文献计量学分析

目的:分析新型冠状病毒感染(COVID-19)相关心律失常的文献,探索该领域的研究现状、热点并预测未来的趋势,为后来的研究者提供借鉴。方法:选择Web of Science的核心合集数据库,每项研究都进行了文献计量和视觉分析,使用CiteSpace和VOSviewer软件生成知识图谱。结果:共鉴定出768篇文章,发文涉及美国、意大利和中国为首的319个国家/地区和4 366个机构,领先的研究机构是梅奥诊所和哈佛医学院。New England Journal of Medicine是该领域最常被引用的期刊。在6 687位作者中,Arbelo Elena撰写的研究最多,Guo T被共同引用的次数最多,心房纤颤是最常见的关键词。结论:随着COVID-19的暴发,对COVID-19所致新发/进行性心律失常事件的研究蓬勃发展,未来的研究者可能会对COVID-19感染后新发或遗留的快速性心律失常/缓慢性心律失常的发生机制进行进一步的探索。

麻杏石甘汤干预COVID-19肺炎的网络药理学研究及分子对接分析

目的:运用网络药理学与分子对接研究方法探讨麻杏石甘汤干预COVID-19肺炎的作用机制。方法:经TCMSP、HTDocking数据库检索麻杏石甘汤所有药物的成分并进行ADME筛选得到活性成分,在Uniport数据库检索其发挥治疗作用可能的基因靶点;借助GeneCards、PharmGKB等数据库检索COVID-19肺炎相关基因靶点,利用Cytoscape软件构建药物-活性成分-靶基因-疾病网络;借助String系统构建PPI网络,并进行拓扑学特征分析,筛选核心基因;利用R语言的clusterProfiler包对核心基因进行GO、KEGG富集分析;利用AutoDock Vina软件对疾病靶蛋白及药物活性成分进行分子对接验证。结果:共筛选出麻杏石甘汤与COVID-19肺炎交集基因靶点67个。PPI网络分析显示,其发挥治疗作用的核心基因靶点有MAPK1、MAPK3、STAT1、JUN等8个。GO富集分析显示,相关生物过程1863个,分子功能95个,细胞成分36个;KEGG富集分析显示,相关作用通路167条。分子对接结果显示,麻杏石甘汤活性成分槲皮素、山奈酚、熊果酸等与核心基因靶点JUN、MAK1、IL2等有较好的结合活性。结论:麻杏石甘汤可能以槲皮素、山奈酚等为物质基础,多成分、多靶点、多通路、相互协同发挥抑制病毒活性,降低炎症反应,保护肺部组织,从而对COVID-19肺炎起到积极的干预作用。

低频脉冲磁场诱导TRPC1改善COVID-19患者康复期下肢的肌肉无力症状

背景:肌肉无力是新型冠状病毒(COVID-19)感染后的常见症状,影响康复期人体日常活动能力。在强度1.5 mT,频率3300 Hz的低频脉冲磁场刺激下可通过诱导和激活经典瞬时感受器电位通1(classical transient receptor potential channel 1,TRPC1),提升人体骨骼肌的最大自主收缩力与力量耐力,对肌肉组织产生一系列生理支持效应,该手段是否会改善新型冠状病毒肺炎患者康复期的肌无力症状尚无研究。目的:选用低频脉冲磁场对新型冠状病毒肺炎患者下肢肌群进行磁刺激,以观察该刺激对新型冠状病毒肺炎患者康复期下肢肌群肌无力改善的影响。方法:招募胶体金法抗原检测试剂(COVID-19)为阳性并伴有肌肉无力症状的新型冠状病毒(奥密克戎毒株)感染患者14例,将所有受试者随机分成2组,分别为接受磁场刺激的试验组和接受假治疗的对照组。试验总时长3周,试验组每隔48 h对腿部进行低频脉冲磁刺激,对照组与试验组干预流程一致但给予假刺激,两组患者均不被告知磁刺激仪器是否运行,两组患者共进行9次操作,随后观察两组患者下肢局部肌群最大自主收缩力、腿部爆发力与力量耐力的变化情况。结果与结论:①在采集的8个局部肌群中,试验组患者7个局部肌群在经过3周的低频脉冲磁场刺激,最大自主收缩力值均增长。对照组除3个肌群最大自主收缩力自行增长改善以外,其他肌群肌力无提升。②试验组的左腿前群与双腿后群提升率显著高于对照组。③两组的纵跳摸高高度与膝关节峰值角速度相比试验前测均提升,试验组摸高高度提升率高于对照组。④在疲劳状态下,试验组膝关节峰值角速度下降率显著下降,对照组膝关节峰值角速度下降率无显著性变化;试验组摸高高度下降率显著下降,而对照组摸高高度下降率无显著性变化。⑤上述数据证实,在强度1.5 mT,频率3300 Hz的低频脉冲磁场刺激方案下,新型冠状病毒肺炎患者在康复期经过3周的低频脉冲磁场刺激相比人体自愈过程可使更多的下肢局部肌群肌力获得提升,对基于腿部爆发力的全身协调发力能力及功能状态明显改善。因此,低频脉冲磁场刺激可作为一种改善新冠感染患者下肢肌肉无力症状的有效、非运动的康复手段。

COVID-19诊疗信息、中医证型分布及组方用药规律的文献研究

目的利用数据挖掘技术深入探究新型冠状病毒感染(COVID-19,简称新冠感染)患者的诊断、中医证型分布以及药物使用规律,以期为中医药治疗新冠感染提供有效的参考依据。方法通过搜索,可以获取来自国家卫生健康委员会和全国各地的《新型冠状病毒肺炎诊疗方案》内涉及的中医证型和中医药防治方案,以及中国生物医学文献服务系统、知网、维普、万方数据库收录的治疗新冠感染相关文献共249份。对文献通过筛选、整理和去重并建立中药复方数据库、诊疗信息数据库、证型数据库,运用频数分析、频率分析进行探究。结果新冠感染患者常见的症状频数较高的为咳嗽、咽干咽痛、发热、纳差、乏力;大多数患者呈淡红舌、红舌,脉象为滑脉、滑数脉;中医证型频数较高的有湿毒郁肺证、湿热蕴肺证、肺脾气虚证、寒湿郁肺证、气阴两伤证、兼夹瘀血证。此外,共纳入491首治疗新冠感染中药复方,涉及中药227味,得到高频中药共64个,药物类别以清热药、补益药、解表药、化痰止咳平喘药、化湿药为主;药性以温、平、寒为主,药味以甘、辛、苦为主,归经中归肺、脾、胃经中药居多;聚类分析结果根据中药性能将治疗新冠感染的高频药物聚为8类较好。结论中医药治疗新型冠状病毒感染用药具有以下特点:补益药用药次数较多体现攻邪不忘扶正;解表、清热、攻下、化湿、利湿、渗湿药物俱全体现多种逐邪之法;药类以清热药、补益药、化湿药、化痰止咳平喘药、解表药为主,彰显新冠感染基本治法为清热化湿、止咳平喘、补养气阴。可为指导临床用药及研发新药提供一定的参考与借鉴。

显微镜下多血管炎相关间质性肺病合并COVID-19患者疫苗保护作用初探

目的分析显微镜下多血管炎(MPA)相关间质性肺病(ILD)患者合并新型冠状病毒肺炎(COVID-19)的临床特征,初步探究新型冠状病毒(SARS-CoV-2)疫苗的保护作用。方法纳入确诊的MPA-ILD患者,同时符合《新型冠状病毒感染诊疗方案(第十版)》制定的COVID-19诊断标准,且均有明确SARS-CoV-2抗原或核酸检测阳性证据。收集并分析患者临床资料,ILD影像学分型,SARS-CoV-2疫苗接种情况、临床分型及预后。结果共纳入37例MPA-ILD患者,女14例,男23例。32例在并发COVID-19时MPA病情处于缓解期,31例同时维持免疫抑制剂或生物制剂治疗。ILD的影像学类型以寻常型间质性肺炎(15例)和非特异性间质性肺炎(14例)为主,剩余8例分型不确定。COVID-19分型中,27例为轻症,5例因COVID-19死亡。11例未接种疫苗,26例接种SARS-CoV-2灭活疫苗,其中11例完成3剂次加强免疫。接种疫苗患者COVID-19轻症比例高于未接种疫苗组(P=0.038)。多因素分析显示接种疫苗为MPA-ILD患者合并COVID-19住院(OR=0.045,95%CI:0.004~0.472,P=0.010)及非轻症感染(OR=0.049,95%CI:0.005~0.517,P=0.012)的独立保护因素。同时MPA处于缓解期为COVID-19非轻症感染的保护因素(OR=0.021,95%CI:0.001~0.459,P=0.014)。结论接种SARS-CoV-2疫苗及MPA病情处于缓解期有可能减轻MPA患者合并COVID-19的严重程度。

全球COVID-19疫情主要预测模型比较分析

目的新冠感染病死率预测对于深入理解新冠病毒严重性、合理配置医疗资源及开展针对性防疫策略有重大意义。方法本研究依据新冠病毒变异优势株,将疫情发展划分四个时期,选取美国、印度、巴西、墨西哥、秘鲁、中国六个国家以及全球平均水平的病死率为研究对象。运用灰色模型、指数平滑模型、ARIMA模型、支持向量机、Prophet和LSTM模型六个模型进行拟合预测,探讨各模型的优缺点和适用性,选取效果最优的模型对全球和重点国家的病死率进行预测。结果模型比较显示多种模型各有优缺点,经预测,多数国家的累计确诊人数和累计死亡人数增长速度减缓,发展趋势逐渐平稳。结论传统时间序列模型适于发展趋势平稳、有限样本的预测;而机器学习模型更适用于波动型变化数据,可进行大样本预测,进一步外推,运用到其他卫生领域的研究。

COVID-19疫情防控常态化时期社会工作者心理健康水平调查及影响因素分析:以北京市朝阳区为例

目的了解COVID-19疫情防控常态化期间,社工焦虑、抑郁、睡眠障碍发生情况并分析其影响因素。方法采用分层整群抽样法,于2021年11月—2022年3月期间选取北京市朝阳区酒仙桥、望京、太阳宫、十八里店、孙河5个街道的全部社工为研究对象(社工组),并以该5个街道对应社区医院且具有相同年龄范围的在职一线医护人员(医护组)、社区居民(居民组)为对照人群。社工组、医护组、居民组比例为1∶1∶1。采用问卷星平台,向社工、医护人员、社区居民微信群发放电子问卷展开调查。比较3组焦虑、抑郁、睡眠障碍筛查阳性率,并采用多因素Logistic回归和决策树分析社工焦虑、抑郁、睡眠障碍的影响因素。结果共回收问卷954份,其中62份不合格予以剔除,最终纳入892份(935%)有效问卷进行数据分析。其中社工组372份(417%),医护组262份(294%),居民组258份(289%)。社工组焦虑、抑郁、睡眠障碍筛查阳性率分别为153%、220%、481%,较医护组(76%、103%、305%)和居民组(70%、85%、295%)明显升高(P均<0001)。多因素Logistic回归显示,家庭负担(OR=180,95%CI:109~296)、中文版压力知觉量表(Chinese perceived stress scale,CPSS)评分(OR=134,95%CI:124~145)是社工焦虑的独立影响因素,CPSS评分(OR=129,95%CI:120~139)、社会支持评定量表(social support rating scale,SSRS)评分(OR=096,95%CI:092~100)是社工抑郁的独立影响因素,有精神疾病家族史(OR=491,95%CI:127~1894)、CPSS评分(OR=120,95%CI:114~127)、SSRS评分(OR=095,95%CI:091~098)是社工睡眠障碍的独立影响因素。决策树分析结果与多因素Logistic回归分析结果基本一致,家庭负担、CPSS评分、SSRS评分是影响社工心理健康的重要变量,其中CPSS评分与社工焦虑、抑郁、睡眠障碍均呈强关联。结论在COVID-19疫情防控常态化时期,相较于医护人员和社区居民,社工表现出更高水平的心理健康问题。压力知觉、社会支持为社工心理健康的重要影响因素,尤其以压力知觉的影响为著。

系统性红斑狼疮合并COVID-19住院患者的临床特征分析

目的探讨系统性红斑狼疮(SLE)合并新型冠状病毒(SARS-CoV-2)感染住院患者的临床特点。方法选取2022年12月—2023年2月于南昌大学第一附属医院风湿免疫科就诊且确诊为COVID-19的SLE患者为研究对象,根据是否住院治疗将其分为未住院组和住院组,比较两组患者的人口学数据、临床症状和实验室检查结果。评估淋巴细胞/单核细胞(LMR)、中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)、系统性免疫炎症指数(SⅡ)、SⅡ/白蛋白、红细胞沉降率/淋巴细胞(ELR)和C反应蛋白/淋巴细胞(CLR)等指标对SLE合并COVID-19患者住院的影响。结果两组患者在年龄、糖皮质激素剂量、SLEDAI评分、红细胞沉降率、C反应蛋白、血小板、淋巴细胞、白蛋白、NLR、PLR、LMR、CLR、ELR、SⅡ和SⅡ/ALB等方面存在统计学差异(P<0.05)。多因素Logistic回归分析显示,CLR(OR=1.16)、糖皮质激素剂量(OR=1.11)及SLEDAI评分(OR=1.23)为SLE合并COVID-19住院患者的临床特点。ROC曲线分析显示,CLR曲线下面积(AUC)为0.751,其灵敏度为50.0%,特异度为94.0%;糖皮质激素剂量的AUC为0.778,其灵敏度为76.9%,特异度为75.9%;SLEDAI的AUC为0.754,其灵敏度为50.0%,特异度为91.6%。结论对于SLE合并COVID-19住院患者而言,较高的CLR、糖皮质激素剂量及SLEDAI评分为其临床特点。

Clinical application of COVID-19 vaccine in liver transplant recipients

Background:Solid organ transplant(SOT)activities,such as liver transplant,have been greatly influenced by the pandemic of coronavirus disease 2019(COVID-19),a disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Immunosuppressed individuals of liver transplant recipients(LTRs)tend to have a high risk of COVID-19 infection and related complications.Therefore,COVID-19 vaccination has been recommended to be administered as early as possible in LTRs.Data sources:The keywords“liver transplant”,“SARS-CoV-2”,and“vaccine”were used to retrieve articles published in PubMed.Results:The antibody response following the 1st and 2nd doses of vaccination was disappointingly low,and the immune responses among LTRs remarkably improved after the 3rd or 4th dose of vaccination.Although the 3rd or 4th dose of COVID-19 vaccine increased the antibody titer,a proportion of patients remained unresponsive.Furthermore,recent studies showed that SARS-CoV-2 vaccine could trigger adverse events in LTRs,including allograft rejection and liver injury.Conclusions:This review provides the recently reported data on the antibody response of LTRs following various doses of vaccine,risk factors for poor serological response and adverse events after vaccination.

规律运动在防治COVID-19中的研究进展

新型冠状病毒病(coronavirus disease-19,COVID-19)是由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)感染引起的以呼吸系统症状为主的疾病。多项研究证明,规律运动对预防COVID-19、增强治疗效果、避免不良预后具有重要作用。本文梳理了运动在COVID-19防治前、中、后的作用及可能机制,运动可通过调节ACE2/Ang(1-7)/Mas轴、增强免疫力和心肺功能、抑制炎症因子和氧化应激、调节肠道菌群稳态以及改善心理状态等途径发挥作用,进而总结出COVID-19防治不同阶段的运动处方,在对运动防治COVID-19全面总结的同时,也为后疫情时代类似呼吸道传染疾病的预防和治疗提供借鉴和参考。

托珠单抗治疗COVID-19导致继发感染风险的Meta分析

目的通过Meta分析评估托珠单抗(tocilizumab,TCZ)治疗新型冠状病毒感染(corona virus disease2019,COVID-19)导致的继发感染风险,为托珠单抗在COVID-19患者中应用的安全性提供循证依据。方法在The Cochrane Library、PubMed、Web of Science、中国知网、中国生物医学文献数据库以及万方数据库中检索了2019年12月19日至2022年12月30日期间使用托珠单抗治疗COVID-19患者的相关研究,筛选并提取文献中发生继发感染的数据,利用RevMan 5.4.1进行Meta分析。结果共筛选了1691篇参考文献,纳入18项研究,涉及3933名患者。托珠单抗+标准治疗组继发感染发生率为19.14%(331/1729),标准治疗组继发感染发生率为12.11%(267/2204)。Meta分析结果显示,托珠单抗+标准治疗组继发感染发生率高于标准治疗组[RR=1.35,95%CI(1.05,1.74),P=0.02]。亚组分析显示,使用不同剂量的托珠单抗发生继发感染的风险不同。托珠单抗给药剂量为400~800 mg/d的亚组继发感染发生率明显高于标准治疗组,差异具有统计学意义[RR=1.48,95%CI(1.19,1.84),P=0.0004];≤400 mg/d继发感染发生率也显著高于标准治疗组,差异具有统计学意义[RR=1.87,95%CI(1.28,2.72),P=0.001];托珠单抗给药剂量为6~8 mg/kg亚组与标准治疗组比较差异无统计学意义。结论与标准治疗相比,托珠单抗可能增加COVID-19患者发生继发感染的风险,临床给药前应仔细评估使用托珠单抗治疗的利益和风险。但是,目前仍需要更多大样本、高质量的研究来进一步评估。

基于对比学习MocoV2的COVID-19图像分类

肺炎是一种常见多发感染性疾病,老年人和免疫力较弱者容易感染,尽早发现有助于后期治疗。肺部病变的位置、密度和清晰度等因素会影响肺炎图像分类的准确性。随着深度学习的发展,卷积神经网络被广泛应用于医学图像分类任务中,然而网络的学习能力依赖训练样本的数量和标签。针对电子计算机断层扫描(Computed Tomography,CT)的肺炎图像分类研究,提出一种基于自监督对比学习的网络模型(MCLSE),可以从无标记的数据中学习特征,提高网络模型的准确率。本文模型(MCLSE)首先设计辅助任务,从无标记的图像中挖掘表征完成预训练,提高模型在向量空间中学习数据映射关系的能力。其次,使用卷积神经网络提取特征,为了有效捕获更高层次的特征信息选择SENet网络改进分类模型,建模特征通道的相关性。最后,用训练好的权重加载改进后的分类模型中,下游任务中使用标记数据再次训练网络。在公开数据集SARS-CoV-2 CT和CT Scans for COVID-19 Classification上进行实验,实验结果表明MCLSE对整体样本分类的准确率分别达到99.19%和99.75%,较主流模型有很大提升。