Infection rate and factors affecting close contacts of COVID-19 cases: A systematic review

Long-Term Effects of the COVID-19 Open Strategy on the Mental Health of Chinese University Students: A Prospective Cohort Study

Background

In December 2022, the Chinese government shifted its COVID-19 prevention and control policy to full openness, leading to a widespread pandemic within a short period. This study aimed to examine the trajectories of stress, anxiety, and depressive symptoms among Chinese university students within 1 year after the implementation of the open policy. Additionally, it investigated the influence of sleep quality, psychological resilience, and medical specialization on these psychological trajectories.

Methods

A cohort study was conducted among Chinese university students using stratified sampling. Follow-up assessments were conducted at three time points: T1 (December 2022-January 2023), T2 (May-June 2023), and T3 (December 2023-January 2024). Generalized Estimating Equations were used to estimate mean differences in symptom levels over time and to examine the influence of sleep quality, psychological resilience, and medical specialization on these changes.

Results

At T1, a total of 2,062 university students were recruited. By T3, the follow-up rate was 63.43%, resulting in a final analytical cohort of 1,308 participants. Among them, 769 (58.8%) were female, and 539 (41.2%) were male. The majority (54.7%, n = 716) were between 19 and 22 years old. Stress, anxiety, and depression levels were highest among Chinese university students at the beginning of the open policy and gradually decreased over the following year. Students with poor sleep quality and poor psychological resilience exhibited worsening psychological trajectories, which showed more severe and persistent symptoms. Medical and Nonmedical students consistently exhibited similar psychological trajectories.

Conclusions

Collectively, the present study indicated that the change of COVID-19 prevention and control policy had more serious negative impacts on the mental health of Chinese university students than the epidemic itself. Thus, strengthening psychological treatments and psychosocial interventions for university students would be crucial in the context of a protracted infectious disease epidemic.

Close contacts of xenograft recipients: Ethical considerations due to risk of xenozoonosis

With decades of pre-clinical studies culminating in the recent clinical application of xenotransplantation, it would appear timely to provide recommendations for operationalizing oversight of xenotransplantation clinical trials. Ethical issues with clinical xenotransplantation have been described for decades, largely centering on animal welfare, the risks posed to the recipient, and public health risks posed by potential spread of xenozoonosis. Much less attention has been given to considerations relating to potentially elevated risks faced by those who may care for or otherwise have close contact with xenograft recipients. This paper examines the ethical and logistical issues raised by the potential exposure to xenozoonotic disease faced by close contacts of xenotransplant recipients-defined herein as including but not limited to caregivers, household contacts, and sexual partners-which warrants special attention given their increased risk of exposure to infection compared to the general public. We discuss implications of assent or consent by these close contacts to potentially undergo, along with the recipient, procedures for infection screening and possible quarantine. We then propose several options and recommendations for operationalizing oversight of xenotransplantation clinical trials that could account for and address close contacts' education on and agency regarding the risk of xenozoonosis.

Awareness, Attitude, and Knowledge Among the Healthcare Workers in China at the Onset of the Oversea Monkeypox Outbreak

BACKGROUND

The outbreak of monkeypox in several nonendemic countries has been reported since May 2022. In the context of the COVID-19 pandemic, it is important to examine how healthcare workers (HCWs) respond to the monkeypox epidemic. Having been involved in the fight against COVID-19 resurgence for nearly 3 years, how HCWs in China respond to the oversea monkeypox outbreak remains unclear.

OBJECTIVE

To investigate the awareness, perceived risk, attitude and knowledge about monkeypox among HCWs in China.

DESIGN

A cross-sectional survey.

PARTICIPANTS

Physicians and nurses from 13 hospitals in Suizhou, China, were contacted through membership of the Physicians' and Nurses' Association.

MAIN MEASURES

Responses regarding their awareness, risk perception, attitude, behavior, and knowledge about the outbreak of monkeypox were collected anonymously during the second month of the outbreak between 15 and 21 June 2022.

KEY RESULTS

Of the 395 physician and 1793 nurse respondents, most had heard of the oversea monkeypox outbreak (physicians 93%, nurses 88%). More than 30% thought there existed an infection risk for themselves or family members (physicians 42%, nurses 32%). Most agreed that HCWs should pay attention to the outbreak (physicians 98%, nurses 98%). More than half had actively sought expertise (physicians 62%, nurses 52%). Approximately half believed that monkeypox may be transmitted through sexual activity or respiratory droplets, or from mother to fetus in utero (physicians 50%, 62%, 55%; nurses 40%, 60%, and 48%, respectively). Some believed that mask-wearing, hand-washing, and glove-wearing can prevent monkeypox transmission (physicians 78%, 89%, 83%; nurses 77%, 86%, 76%, respectively).

CONCLUSIONS

This study identified high awareness, high perceived risk, and pro-prevention attitudes among HCWs in China at the onset of the oversea multi-country monkeypox outbreak, but low levels of monkeypox-related knowledge. Immediate efforts are needed to fill in their knowledge gap, particularly regarding the transmission routes and prevention measures.

A network meta-analysis of risk factors of infection among close contacts of COVID-19

Objective

We aimed to use network meta-analysis to compare the impact of infection risk factors of close contacts with COVID-19, identify the most influential factors and rank their subgroups. It can provide a theoretical basis for the rapid and accurate tracking and management of close contacts.

Methods

We searched nine databases from December 1, 2019 to August 2, 2023, which only took Chinese and English studies into consideration. Odd ratios (ORs) were calculated from traditional meta-estimated secondary attack rates (SARs) for different risk factors, and risk ranking of these risk factors was calculated by the surface under the cumulative ranking curve (SUCRA).

Results

25 studies with 152647 participants identified. Among all risk factors, the SUCRA of type of contact was 69.6 % and ranked first. Among six types of contact, compared with transportation contact, medical contact, social contact and other, daily contact increased risk of infection by 12.11 (OR: 12.11, 95 % confidence interval (CI): 6.51-22.55), 7.76 (OR: 7.76, 95 % CI: 4.09-14.73), 4.65 (OR: 4.65, 95 % CI: 2.66-8.51) and 8.23 OR: 8.23, 95 % CI: 4.23-16.01) times, respectively. Overall, SUCRA ranks from highest to lowest as daily contact (94.7 %), contact with pollution subjects (78.4 %), social contact (60.8 %), medical contact (31.8 %), other (27.9 %), transportation contact (6.4 %).

Conclusion

The type of contact had the greatest impact on COVID-19 close contacts infection among the risk factors we included. Daily contact carried the greatest risk of infection among six types of contact, followed by contact with pollution subjects, social contact, other, medical contact and transportation contact. The results can provide scientific basis for rapid assess the risk of infection among close contacts based on fewer risk factors and pay attention to high-risk close contacts during management, thereby reducing tracking and management costs.

Tracking trends in COVID-19 vaccines based on 47 different vaccines: A bibliometric review

The COVID-19 epidemic in December 2019 had a significant negative impact on people's health and economies all across the world. The most effective preventive measure against COVID-19 is vaccination. Therefore, the development and production of COVID-19 vaccines is booming worldwide. This study aimed to analyze the current state of that research and its development tendency by bibliometrics. We conducted a thorough search of the Web of Science Core Collection. VOSviewer1.6.18 was used to perform the bibliometric analysis of these papers. A total of 6,325 papers were finally included. The USA maintained a top position worldwide. Shimabukuro Tom T and Harvard University were the most prolific author and institution. The Vaccines was the most published journal. The research hotspots of COVID-19 vaccines can be classified into vaccine hesitancy, vaccine safety and effectiveness, vaccine immunogenicity, and adverse reactions to vaccines. Studies on various vaccination types have also concentrated on efficacy against continuously developing virus strains, immunogenicity, side effects, and safety.

Infection rate among close contacts of patients with coronavirus disease in Japan: a descriptive study and literature review

Background

In Japan, on April 20, 2020, the definition of a close contact regarding coronavirus disease (COVID-19) was changed from a long-term contact time to a specified contact time of 15 min and from a contact distance of 2 m to 1 m.

Objectives

We aimed to determine the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rate among close contacts of patients with COVID-19 and determine the impact of the infection on transmission among close contacts.

Methods

The numbers of SARS-CoV-2 tests, SARS-CoV-2-positive cases, and close contacts of patients with COVID-19 were assessed between March 2020 and February 2021 in Fukui Prefecture, Japan. The study period was subdivided into 3 periods. The second and third period contained data with the changed definition of close contact.

Results

Overall, 32,238 SARS-CoV-2 tests were performed. There were 545 patients with COVID-19 and 1487 close contacts, of whom 267 tested positive. The highest infection rate occurred in period 3. Distance, protective measures, and contact time with COVID-19 patients influenced the increased infection rate. The infection rate showed a rising trend from 11.1% in period 1 to 19.2% and 20.0% in periods 2 and 3, respectively (Cochran-Armitage test; P < 0.004). Multivariate analysis revealed that female sex was an independent risk factor for infection of close contacts (odds ratio: 2.23; 95% confidence interval: 1.700-2.930).

Conclusions

Female sex is a risk factor for transmission by close contacts. The rate of infection among close contacts may be associated with contact time, contact distance, and protective measures.