Influencing factors of patients' trust in nurses during the COVID-19 pandemic: a mixed-methods study.

OBJECTIVE: This study aimed to investigate the nurse-patient trust among in-patients in the context of the COVID-19 epidemic; it further analyzed the related influencing factors, which will provide a theoretical basis for developing corresponding measures. METHODS: This study employed a mixed-method design and analyzed 149 patients at the Hongqi Hospital, affiliated with Mudanjiang Medical University, from December 2020 to February 2021. Quantitative analysis was carried out using the "Nurse Patient Trust Scale," and qualitative analysis was performed using a semi-structured interview with in-patients. RESULTS: The average score on the scale was 46.65 ±2.83, and the scores of the two dimensions were: 23.24 ±1.51 for ability and peace of mind, and 23.32 ±1.53 for attitude and care. According to the interview data, the factors included three aspects: a comfortable hospital environment and humane management measures; the nurse's own competence; effective communication with patients. CONCLUSION: During the COVID-19 epidemic, there are still many factors affecting patients' trust in nurses that can be addressed by taking different measures. All these factors must be considered by the relevant managers and clinical nursing staff to maintain a better nurse-patient trust relationship.

Impacting factors and sources of perceived stress by home-quarantined residents in Shanghai during COVID-19 epidemic.

BACKGROUND: Home-quarantine is one of the most common measures implemented to prevent or minimize the transmission of COVID-19 among communities. This study assessed stress levels of the home-quarantined residents in Shanghai during a massive wave of COVID-19 epidemic this year, explored the stress sources perceived by the respondents, and analyzed the association between each of the sociodemographic factors and the stress level. METHODS: This online survey was launched during April 23 - 30, 2022, the early stage of a massive wave of COVID-19 in Shanghai, China. Participants were quarantined-residents negative for COVID-19. They were asked to list some situations that were their major concerns and perceived stressful, in addition to sociodemographic and COVID-19 related information. Moreover, they were asked to complete the Perceived Stress Scale-14 (PSS-14) for the assessment of stress level. RESULTS: A total of 488 valid questionnaires were collected from 192 male and 296 female respondents. Overall, 207 persons (42.42%) presented high stress level (PSS-14 score ≥43). The top three concerns perceived stressful by respondents are "not allowed to go outdoors", "uncertain duration of the epidemic", and "lack of food supply". Fewer than 50% of the respondents perceived the other situations stressful. Higher proportions of young adults (≤ 29 years old), males, unemployed, singles, and those with low income (≤ 1999 yuan/month) perceived high stress compared to their counterparts, none of COVID-19 related factors is associated with the stress level, including location of residence, result of nucleic acid test, knowledge about COVID-19, whether vaccinated, and quarantine duration. CONCLUSION: Home-quarantine applied to people negative for COVID-19 led to a lot of major concerns that may be perceived stressful, whereas the virus-related factors did not show significant impact on mental health of the respondents.

A Beta Strain-Based Spike Glycoprotein Vaccine Candidate Induces Broad Neutralization and Protection against SARS-CoV-2 Variants of Concern.

The coronavirus disease 2019 (COVID-19) pandemic is still ongoing. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) are circulating worldwide, making it resistant to existing vaccines and antiviral drugs. Therefore, the evaluation of variant-based expanded spectrum vaccines to optimize the immune response and provide broad protectiveness is very important. In this study, we expressed spike trimer protein (S-TM) based on the Beta variant in a GMP-grade workshop using CHO cells. Mice were immunized twice with S-TM protein combined with aluminum hydroxide (Al) and CpG Oligonucleotides (CpG) adjuvant to evaluate its safety and efficacy. BALB/c immunized with S-TM + Al + CpG induced high neutralizing antibody titers against the Wuhan-Hu-1 strain (wild-type, WT), the Beta and Delta variants, and even the Omicron variant. In addition, compared with the S-TM + Al group, the S-TM + Al + CpG group effectively induced a stronger Th1-biased cell immune response in mice. Furthermore, after the second immunization, H11-K18 hACE2 mice were well protected from challenge with the SARS-CoV-2 Beta strain, with a 100% survival rate. The virus load and pathological lesions in the lungs were significantly reduced, and no virus was detected in mouse brain tissue. Our vaccine candidate is practical and effective for current SARS-CoV-2 VOCs, which will support its further clinical development for potential sequential immune and primary immunization. IMPORTANCE Continuous emergence of adaptive mutations of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to challenge the use and development of existing vaccines and drugs. The value of variant-based vaccines that are capable of inducing a higher and broader protection immune response against SARS-CoV-2 variants is currently being evaluated. This article shows that a recombinant prefusion spike protein based on a Beta variant was highly immunogenic and could induced a stronger Th1-biased cell immune response in mice and was effectively protective against challenge with the SARS-CoV-2 Beta variant. Importantly, this Beta-based SARS-CoV-2 vaccine could also offer a robust humoral immune response with effectively broad neutralization ability against the wild type and different variants of concern (VOCs): the Beta, Delta, and Omicron BA.1 variants. To date, the vaccine described here has been produced in a pilot scale (200L), and the development, filling process, and toxicological safety evaluation have also been completed, which provides a timely response to the emerging SARS-CoV-2 variants and vaccine development.

Systematic review and meta-analysis of neonatal outcomes of COVID-19 vaccination in pregnancy.

BACKGROUND: The safety of coronavirus disease 2019 (COVID-19) vaccines during pregnancy is a particular concern. Here, we addressed the neonatal outcomes after maternal vaccination of COVID-19 during pregnancy. METHODS: We systematically searched PubMed, EMBASE, and the WHO COVID-19 Database for studies on neonatal outcomes after maternal COVID-19 vaccination from inception to 3 July 2022. Main neonatal outcomes were related to preterm, small for gestation (SGA), NICU admission, low Apgar score at 5 min (<7), and additional neonatal outcomes such as gestation <34 weeks, low birth weight and some neonatal morbidity were all also analyzed. RESULTS: A total of 15 studies were included. We found that maternal vaccination during pregnancy was related to the reduction rates of Preterm, SGA, Low Apgar score at 5 min (<7). In addition, there was no evidence of a higher risk of adverse neonatal outcomes after maternal vaccination of COVID-19 during pregnancy, including NICU admission, preterm birth with gestation <34 weeks, low birth weight, very low birth weight, congenital anomalies, and so on. CONCLUSIONS: COVID-19 vaccination in pregnant women does not raise significant adverse effects on neonatal outcomes and is related to a protective effect on some neonatal outcomes. IMPACT: Present study has addressed the neonatal outcomes after maternal vaccination of COVID-19 during pregnancy. COVID-19 vaccination in pregnant women does not raise significant adverse effects on neonatal outcomes and is related to a protective effect on some neonatal outcomes. The present study could encourage pregnant women to be vaccinated against COVID-19.

A new strategy based on PCA for inter-batches quality consistency evaluation.

Due to cultivation position, climate, harvest times, storage conditions and processing method, the evaluation of intra- and inter- batches quality consistency of botanical drugs has always been a thorny problem since it concerns safety and efficacy. The combination of fingerprint based on instrumental analysis and chemometrics is a common evaluation method in recent years. The differences between groups can be judged intuitively and superficially through principal component analysis (PCA) multi-dimensional score plots, but there is a lack of scientific and quantitative index to quantify the differences between groups. How to quantify the difference between groups is basically a blank area of research. Based on traditional F-statistic, we proposed a new F*-statistic to quantify the difference between groups in PCA score plots from the perspective of statistics. As the results revealed, the calculated F*-statistic was 2.58, smaller than the critical value 3.17 (α = 0.05), which indicated that there was no significant difference between groups. Our study add another dimension for PCA application, which offers a new strategy to quantify differences between groups by a new perspective, namely, a combination of fingerprint, chemometrics and statistics to evaluate inter-batches quality consistency quantitatively and objectively. Therefore, this manuscript could provide new ideas and technical references for the quality consistency evaluation of natural drugs, thus better guarantee their clinical efficacy and safety, and better promote industrial development.

Discovery of potential anti-SARS-CoV-2 drugs based on large-scale screening in vitro and effect evaluation in vivo.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global crisis. Clinical candidates with high efficacy, ready availability, and that do not develop resistance are in urgent need. Despite that screening to repurpose clinically approved drugs has provided a variety of hits shown to be effective against SARS-CoV-2 infection in cell culture, there are few confirmed antiviral candidates in vivo. In this study, 94 compounds showing high antiviral activity against SARS-CoV-2 in Vero E6 cells were identified from 2,580 FDA-approved small-molecule drugs. Among them, 24 compounds with low cytotoxicity were selected, and of these, 17 compounds also effectively suppressed SARS-CoV-2 infection in HeLa cells transduced with human ACE2. Six compounds disturb multiple processes of the SARS-CoV-2 life cycle. Their prophylactic efficacies were determined in vivo using Syrian hamsters challenged with SARS-CoV-2 infection. Seven compounds reduced weight loss and promoted weight regain of hamsters infected not only with the original strain but also the D614G variant. Except for cisatracurium, six compounds reduced hamster pulmonary viral load, and IL-6 and TNF-α mRNA when assayed at 4 d postinfection. In particular, sertraline, salinomycin, and gilteritinib showed similar protective effects as remdesivir in vivo and did not induce antiviral drug resistance after 10 serial passages of SARS-CoV-2 in vitro, suggesting promising application for COVID-19 treatment.

Isolation and identification of two strains of severe acute respiratory syndrome coronavirus 2 from coronavirus disease 2019 patients in Shanghai

Objective To isolate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) from nasal/throat swabs of coronavirus disease 19 (COVID-19) patients. Methods Three nasal/throat swab samples from COVID-19 patients in Shanghai were treated with TPCK trypsin and were used to treat Vero E6 cells inoculated in 96-well plates. When most of the cells showed obvious cytopathy, the cell culture supernatants were collected. We then detected the viral nucleic acid by fluorescent quantitative real-time polymerase chain reaction, and amplified the gene fragment of the virus receptor binding domain (RBD) by reverse transcription polymerase chain reaction. After amplification and culture, the virus was used to infect the Vero E6 cells inoculated in 96-well plates. The cytopathy was observed and the virus protein was detected by immunofluorescence. Results The Vero E6 cells that cultured with two of three nasal/pharyngeal swab samples showed obvious cytopathic effect and newly synthesized viral nucleic acid was detected in the supernatants of the cell culture. The amplified RBD sequence was completely consistent with the corresponding fragment of SARS-CoV-2 isolated earlier. Virus-infected Vero E6 cells showed cytopathies rapidly and could react with the monoclonal antibody against nucleocapsid protein (N protein) and spike protein (S protein) of SARS-CoV-2, and convalescence sera of COVID-19 patients. Conclusion Two SARS-CoV-2 strains were successfully isolated from two nasal/throat swab samples of COVID-19 patients in Shanghai, which provides evidence for the mechanism research on the infection and pathogenesis of SARS-CoV-2 as well as the development of drugs and vaccines against SARS-CoV-2.

The potential association between common comorbidities and severity and mortality of coronavirus disease 2019: A pooled analysis.

BACKGROUD: The association between underlying comorbidities and cardiac injury and the prognosis in coronavirus disease 2019 (COVID-19) patients was assessed in this study. HYPOTHESIS: The underlying comorbidities and cardiac injury may be associated with the prognosis in COVID-19 patients. METHODS: A systematic search was conducted in PubMed, EMBASE, Web of science, and The Cochrane library from December 2019 to July 2020. The odds ratio (OR) and 95% confidence intervals (95% CI) were used to estimate the probability of comorbidities and cardiac injury in COVID-19 patients with or without severe type, or in survivors vs nonsurvivors of COVID-19 patients. RESULTS: A total of 124 studies were included in this analysis. A higher risk for severity was observed in COVID-19 patients with comorbidities. The pooled result in patients with hypertension (OR 2.57, 95% CI: 2.12-3.11), diabetes (OR 2.54, 95% CI: 1.89-3.41), cardiovascular diseases (OR 3.86, 95% CI: 2.70-5.52), chronic obstractive pulmonary disease (OR 2.71, 95% CI: 1.98-3.70), chronic kidney disease (OR 2.20, 95% CI: 1.27-3.80), and cancer (OR 2.42, 95% CI: 1.81-3.22) respectively. All the comorbidities presented a higher risk of mortality. Moreover, the prevalence of acute cardiac injury is higher in severe group than in nonsevere group, and acute cardiac injury is associated with an increased risk for in-hospital mortality. CONCLUSION: Comorbidities and acute cardiac injury are closely associated with poor prognosis in COVID-19 patients. It is necessary to continuously monitor related clinical indicators of organs injury and concern comorbidities in COVID-19 patients.